I- & I net 



Psychology and Pathology of Speech 
Development of the Child 

BY 
EDWARD CONRADI 



A THESIS SUBMITTED TO THE FACUI<TY OF 
CLARK UNIVERSITY, WORCESTER, MASS., IN 
PARTIAL FULFILMENT OF THE REQUIRE- 
MENTS FOR THE DEGREE OF DOCTOR OF 
PHILOSOPHY, AND ACCEPTED ON THE REC- 
OMMENDATION OF G. STANLEY HALL 



Reprinted from the Pedagogical Seminary 
September, 1904, Vol. XI, pp. 327-380 



n 



\ 



/ 



Psychology and Pathology of Speech 
Development of the Child 



BY 
EDWARD CONRADI 



A THESIS SUBMITTED TO THE FACULTY OF 
CLARK UNIVERSITY, WORCESTER, MASS., IN 
PARTIAL FULFILMENT OF THE REQUIRE- 
MENTS FOR THE DEGREE OF DOCTOR OF 
PHILOSOPHY, AND ACCEPTED ON THE REC- 
OMMENDATION OF G. STANLEY HALL 



/' 



Reprinted from the Pedagogical Seminary 
September, 1904, Vol. XI, pp. 327-380 






PSYCHOLOGY AND PATHOLOGY OF SPEECH- 
DEVELOPMENT IN THE CHILD, 



By Edward Conradi, Fellow in Psychology, Clark University. 



The development of language in the child is a subject of 
great importance to the general psychology of language as well 
as to child psychology, and it is as diflScult as it is important. 
In this paper it is the aim to bring together, compare, and 
criticise numerous observations and the interpretations that dif- 
ferent workers in the field have made of the language develop- 
ment of the child both normal and abnormal. The following 
topics will be taken up in the order here given : The Order of 
Development of the Different Sounds; The Recapitulation 
Theory; Word Invention ; The Child's First Word-meanings; 
Stammering; Stuttering; Methods of Curing Stuttering. 

I. Psychology of Speech-Development. 

I. The Order of Development. The vocal language of 
the child probably begins with the first cry after birth. Crying 
forcibly expels the air from the lungs, produces deep inhala- 
tions as they could not be produced in any other way and thus 
develops the whole respiratory system. It is even a rudiment- 
ary language itself since a skillful nurse can interpret the needs 
and moods of the child by its cry. It has, moreover, been 
graphically shown that the muscle innervation of the respira- 
tory system, developed during the early cry period, is the same 
as that used in ordinary speech (12:193 ff. ). 

During the early babble period the child plays with its vocal 
and articulatory organs and makes new sounds for the pleasure 
they give him ; the activity of the speech producing organs is 
automatic, just as that of the legs and arms is. A great num- 
ber of sounds are produced which are not found in our language, 
some of them so complicated that we cannot produce them ; 
among these are the so-called vomitive sounds and the cluck- 
like sounds, found among some primitive people but not in our 
own language. Dr. Hall says (15:132), "It would be difficult 
even with Bell's phonic notation, or with a phonograph, to 
classify the first vocalizations of an infant. ' ' Preyer thinks that 
all sounds necessary for future language are now produced, 
whereas Ament thinks the number of possible sounds is infinite, 
and that it is only with difficulty that the child sinks from this 
wealth of sounds to the meagre level of his mother tongue. 

Gift 
The University 
I2Ap'05 



SPBECH-DEVEIvOPMENT IN THE CHII,D. 51 

5. Darwin, C. A Biological Sketch of an Infant. Mind, 1S77 II 

285-294. 

6. Dewey, J. Psychology of Infant L,anguage. Psychol. Rev I 

63-66. 

7. Egger, E. Observations et Reflexions sur le Development de 

rintelligence et du Langage chez les Enfant. Paris, 1889, pp 
102. ^^ 

8. Erdmann, B. Die Psychologischen Grundlagen der Beziehung 

Zwischen Sprechen u. Denken. Arch. f. Syst. Philos., 1896, II, 
355-416; III, 150-173; VII, 147-176, 316-371; 439-474. 

9. Franke, C. Sprachentwickelung der Kinder und der Men- 

schen. Rein's Encyklopad. Handbuch d. Pad., 1899 VI 
751-794- 

10. FrenzeIv, Fr. Stufen in der Sprachentwickelung des Kindes. 

Kinderfehler, 1902, VII, 25-33, 74-82. 

11. GuTZMANN, H. Des Kindes Sprache und Sprachfehler. Leip- 

zig, 1894, pp. 264. 

12. Die Sprachliche Entwickelung des Kindes und ihre 

Henimungen. Kinderfehler, 1902, VII, 193-216. 

13- Die Sprache des Kindes und der Naturvolker. Ztschft. 

f. Pad. Psy. u. Pathol., 1899, I, 28-40. 

14. Hale, H. The Origin of Language and the Antiquity of Speak- 

ing Man. Trans. Am. Ass. of Adv. of Sci., 1886, XXXV 279- 
323- 

15. Hai,i„ G. S. Notes on the Study of Infants. Ped. Sent., I 1891 

132-138— also ' 

HalIv-Stimpfl. BeitragezurKinderpsychologieund Padagogik. 
Alteuburg, 1902, pp. 45-62. 

16. Idelberger, H. Hauptprobleme des Kindes Sprachentwickel- 

ung. Ztschft. f. Pad. Psy., Pathol, u. Hyg., 1903, V, 241-297 
425-456. 

17. Kirkpatrick, E. a. Number of Words in an Ordinary Vocabu- 

lary, Sci., 1891, XVIII, 107-108. 

18. Lindner, G. Aus dem Naturgarten der Kindersprache, Leip- 

zig, 1898, pp. 122. 

19. LuKENS, H. T. Preliminary Report on the Learning of Lan- 

guage. Ped. Sent., 1894-96, III, 424-460. 

20. Meumann, E. Die Entstehung der Ersten Wortbedeutungen 

beim Kinde. Leipzig, 1902, pp. 69. (Wundts Studien XX). 

21. O1.TUSZEWSKI, W. Die Geistige und Sprachliche Entwickelung 

des Kindes. Berlin, 1897, pp. 43, (also Monatsschft, f. Sprach- 
heilkunde 1896). 

22. Preyer, W. Development of the Intellect. New York, 1889 

PP- 317- 

23. Preyer, W. Infant Mind. New York, 1893, pp. 170. 

24. Rzesnitzek, E. Zur Frage der Psychischen Entwickelung der 

Kindersprache. Breslau, 1899, pp. 35. 

25. SCHULTZE, F. Die Sprache des Kindes. Leipzig, 1887, pp. 46. 

26. SiGiSMUND, B. Kind und Welt, Braunschweig, 1856, pp. 221. 
26a. Sikorsky, J. A. Die Seele des Kindes. Leipzig, 1902, pp. 80. 

27. Stumpf, C. Eigenartige Sprachliche Entwickelung eines Kindes. 

Ztschft. f. Pad. Psy. u. Pathol., 1901, III, 420-447. 
27a. Steinthai,, H. Psychologic und Sprachwissenschaft. Berlin, 
1881, pp. 496. 

28. Stricker, S. Sprachvorstellungen. Wien, 1880, pp. 106. 

29. Sui,i,Y, J. Studies of Childhood. New York, 1896, pp. 517 
29a. Techmer, F. Phonetik. Leipzig. 1880, I, pp. 218. 

30. Taine, M. De L'aquisition du Langage chez les Enfant et 

I'Espece Humaine. Rev. Philos., 1876 (Trans, in Mind, 1877, II 
252-259). 



52 SPEECH-DEVELOPMENT IN THE CHILD. 

31. Thausing, M. Das Naturliche Lautsystem. Leipzig, 1863, pp. 

140. 
31a. Tracy, F. The Language of Childhood. Ani.Jour.Psy.,iS<)y 
5, VI, 63-94. 

32. TiEDEMANN, D. Beobachtuugen liber die Entwickelung der Sce- 

lenthatigkeiten bei Kindern. (pub. 1787). (Ufer) Altenburg, 
1897, pp. 56 (Bibliog.). 

33. ViERORDT, K. VON. Sprechen. Gerhardt's Handbuch, 1881, I, 

454-457- 

34. WuNDT, Wm. Volker-Psychoiogie, I, pt. i, pp. 627; pt. 2, pp. 

644. Leipzig, 1900. 

Pathological. 

35. AlbrechT, G. Bericht-Gutzmann's Poliklinik, 1897 and 1898. 

Med. Pad. Mon. f. d. Gesammte Sprachhlknde, 1898, 65-81; 
1899, 33-40, 65-75. 

36. ArndT, R. Stottern. Real Enc3'clopsedia der Ges. Heilk. 

(2n Ed.), 1889, XIX, 172-178. 

37. Baginsky, a. Schulhygiene. Stuttgart, 1900, II, pp. 428. 

38. Ballet, G. and Tissier, P. Du Begaiement Hysterique. Arch. 

de Neurol., 1890, XX, 1-27. 

39. Bawden, H. H. a Study of Lapses. Psychol. Rev. Supp., 1899- 

1901, III, pp. 122. 

40. Bell, a. M. The Faults of Speech. Washington, D. C, 1898, 

pp. 71. 

41. Berkhan, O. Ueber Storungen der Sprache und Schriftsprache. 

Berlin, 1899, pp. 89. 

42. Bernard, A. G. Stammering, Causes, Treatment and Cure of. 

Loudon, 1889, pp. 71. 

43. BRE.SGEN, M. Ueber den Zusammenhaug von Sprachgebrechen 

mit Nasen- u. Racbenleiden. Med. Pad. Mon. f. d. Ges. 
Sprachhlknde. 1882, 97-102. 

44. Ueber die Bedeutung Behinderter Nasenathmung fiir 

die Geist- u. Sprachliche Entwickelung der Kinder., ibid., 1891, 
204-210. 

45. BiJRGERSTEiN, L. Die Arbeitskurve einer Schulstunde. Ztschft. 

f. Schulgesundheitspflege, 1891, IV, 543-562; 607-627. 

46. TEM CaTE, M. J. Ueber die Untersuchung der Atmyngsbewe- 

gungen bei Sprachfehleru. Med. Pad. Mon. f. d. Ges. Sprach- 
hlknde, 1902, 247-259; 321-341. 

47. Chervin, Note sur la Begayement. Bull. Acad. Roy. de Med. 

de Belg. Brux., 1886, 3s, XX, 24-35. 

48. A Propos du Begayement Hysterique. Arch. d. Neu- 
rologic XXI, 365-374- 

48a. Begaiement et Autres Maladies Fonctionelles de La 

Parole. Paris, 1901, pp. 551. 

49. COeN, R. Ueber die Auwendung der Hypnose bei der Therapie 
des Stotterns. Med. Pad. Mon. f. d. Ges. Sprachhlknde. 1893, 
170-172. 

50. Uebungsbuch fiir Stotterude. Vienna, 1891, pp. 146. 

51. Denhard, R. Das Stottern. Leipzig, 1890, pp. 299. 

52. Gako, T. (Methodof Curing Stuttering). Tokio, Med. Wochen- 

schrift, 1892, No. 749, pp. 5-12. 

53. GrEidenberg, B. S. Ueber das Hysterische Stottern. Neurol. 

Centralblatt, 1895, XIV, 542-547- 

54. GruEnbaum, F. ^ErklaruDg des Stotterns. Leipzig, 1897, pp. 63. 

55. GUTzMANN, A. Offentliche Massnahmengegen Sprachgebrechen 

in Preussen. Med. Pad. Mon. f. d. Ges. Sprachhlknde, 1891, 
i-ii; 41-49. 



SPEECH-DEVELOPMENT IN THE CHILD. 53 

55a. GuTZMANN, A. Das Stottern. Berlin, 1890, pp. 347. 

56. GuTZMANN, A. AND H. Zur Prognose u. Beliatidluug der Auge- 

boreuen Gaumendefekte. Med. Pad. Mou. f. d. Ges. Sprach- 
lilknde, 1893, 65-103. 

57. GuTZMANN, H. Beitrag zu dem Zusammenliang Funktioneller 

Sprachstoruugen u. Krankheiten der Oberen Luftwege. Med. 

Pad. Mon. f. d. Ges. Sprachhlknde, 1901, 309-315. 
58. Periodisches Stottern u. das Vorkoramen des Stot- 

terns bei Verschiedeuen Rassen. Med. Pad. Mon. f. d. Ges. 

Sprachhlknde, 1897, 225-234. 
59. Das Stottern. Frankfort, a. M., 1898. pp. 460. 

60. HarTWELL, E. M. Application of Laws of Phys. Training to 

the Prevention and Cure of Stuttering. Proc. N. E. A., 1893, 
739-749 or School Doc. No. 8, Boston, 1894, pp. 151. 

61. Heymann, F. Ueber das Stottern. Deut. Zeitschft. f. Nerven- 

heilkuude, 1894, V, No. 2 & 3. (Rev. in Mon. f. Sprachheil- 
kunde, 1894, 204-206.) 

62. HiGiER, H. Ueber Hysterisches Stottern. Berl. Klin. Wocheu- 

schft, 1893, 822-826. 

63. HoRRix, H. Ein Fall von Musikalischem Stottern. Med. Pad. 

Mon. f. d. Ges. Sprachhlknde, 1897, 72-73. 

64. Hunt, J. Stammering and Stuttering. London, 1865, pp. 275. 

65. Jastrow, J. The Dreams of the Blind. New Princeton, Rev., 

Jan., 1888. 

66. Kafemann, R. Ueber den Zusamraenhang Gewisser Hals- u. 

Nasenleiden mit Stottern. Med. Pad. Mon. f. d. Ges. Sprach- 
hlknde, 1891, 13-21. 

67. Ueber die Beeinflussung Geistiger Leistungen durch 

Behinderung der Nasenathmung. Kraeplin's Arb., 1902, No. 
3, 435-453. 

67a. KussMAUL, A. Storungen der Sprache. Leipzig, 1885, pp. 299. 

68. Lauei, Die Anwendung der Hypnose bei der Therapie des 

Stotterns. Med. Pad. Mon. f. d. Ges. Sprachhlknde, 1893, 
33-39; 129. 
68a. Lay, W. A. Fiihrer durch den Rechtschreib-Unterncht. Wies- 
baden, 1899, pp. 202. 

69. LiEEMANN, A. Untersuchung u. Behandlung Geistig Zuriick- 

gebliebener Kinder. Berlin, 1898, pp. 36. 

70. — Vorlesungen iiber Sprachstorungen. Berlin, 1898, pp. 

104,4-58+57+48. 
71. Die Psychischen Erscheinungen des Stotterns. Mon. 

f. Psychiat. u. Neurol., IX, 177-184. 
72. Stotternde Kinder. Samml. v. Abh. a. d. Geb. d. 

Pad. Psychol, u. Pathol., VL No. 2, pp.96. 

73. LiNDBERG, K. Zur Haufigkeit des Stotterns bei Schulkindern. 

Med. Pad. Mon. f. d. Ges. Sprachhlknde, 1900, 281-286. 

74. Makuen, G. H. Diagnosis and Treatment of Some Functional 

Forms of Defective Speech. Phil. Med. Jour., 1901, VII, 

251-255- 

75. Medical Statistics of the Provost Marshal General's Bureau. 

1875, II, pp. 424 and 453 (table XVI and table XVIII). 

76. Meringer u. Meyer. Versprechen u. Verlesen. Stuttgart, 

1895. PP- 204. 

77. MielECKe, a. Ueber Storungen der Schriftsprache bei Schul- 

kindern. Med. Pad. Mon. f. d. Ges. Sprachhlknde, 1893, 
40-51; 103-114. 

78. Mygind, H. Ueber die Ursachen des Stotterns. Arch. f. Laryng. 

u. Rhinol., 1898. VIII, 294-307. (Trans, in Annals of Otol., 
Rhiu. Laryng., 1898, VII, 688-697.) 



54 SPEECH-DEVELOPMENT IN THE CHILD. 

79. Neumann, A. Ueber Sprachstorungen und Stotteru beiui. 

Schreibeu. Graz, 1893, pp. 71+19+4- 

80. OivTUSZEWSKi, W. Beitrage zur Lehre von den Sprachstorungen. 

Med. Pad. Mon. f. d. Ges. Sprachhlkude, 1894, 129-151; 65-85. 

1895, 193-217. 1896, 65-86. 1897, 161-186; 200-207. 1898, 129- 
145; 165-178. 1899, 129-143; 161-166. 1903, 33-40. 

81. PiTRES, A. Mutisme et du Begayemeut Hysterique. Rev. de 

Laryngologie, 1890, 745-754- 

82. Remak, E. Palhologie ues Hysteriscben Stotterns. BerL Klin. 

Wochenschft., 1894, 795-797. 

83. Sarbo, von a. Statistik der an Sprachstorungen Leidenden 

Schulkinder Ungarns. Med. Pad. Mon. f. d. Ges. Sprachhl- 
knde, 1901, 65-89. 

84. SsiKORSKi, J. A. Ueber das Stottern. Berlin, 1891, pp. 372. 

85. StrumpelI/, L. Padagogische Pathologie. Leipzig, 1899, pp. 556. 

86. TreiTEIy, L- Stammeln als Folge von Stottern. Berl. Klin. 

Wochenschft, 1891, 964-965. 

87. Ueber Sprachstorungen u. Sprachentwickelung. Arch. 

f. Psychiat. u. Nervenkr, 1892, XXIV, 578-611. 

88. Waldeyer, W. Ueber Somatische Unterschiede der beiden 

Geschlechter. Med. Pad. Mon. f. d. Ges. Sprachhlkude, 

1896, 59-64. 

89. Westergaard, H. Von der Haufigkeit der Sprachgebrechen. 

Med. Pad. Mon. f. d. Ges. Sprachhlknde, 1898, 1-8. 

90. WiNCKLER, E. Ueber den Zusammenhang von Stottern u. 

Nasenleiden. Wien. Med. Wochenschrift, 1890, XL, 1828- 

1832; 1872-1875. 
91. Balbuties cum Rhinolalia Aperta. Med. Pad. Mon. 

f. d. Ges. Sprachhlknde, 1892, 256-272. 
92. Wyllie, J. The Disorders of Speech. Ediuburg, 1894, pp. 495. 



SPEECH-DEVELOPMENT IN THE CHII,D. 3 

Gutzmann is still more conservative than Preyer; he says (13:28) 
the sounds developed during this period are labials and dentals, 
i. e. , the sounds produced in the first and second articulatory 
S3''stems. Wundt says the tendency to utter such a great 
variety of sounds has been inherited physiologically through a 
long series of speech-using ancestors, that soon after birth asso- 
ciation tracts begin to develop which make articulation possible, 
and adds that with sufiicieut data collected from the early la-la 
period it might be proved that, due to hereditary causes, the 
early sounds of children vary somewhat with nationality. As 
a suggestive illustration he quotes sounds uttered from the 12th 
to the 14th week as recorded by Preyer and by K. C. Moore. 
German : am, ma, or, ro, ar, ra, hu, na, om, in, ab, la, ho, 
mo, na, na, an, mg, mb, gr, ha, bu, me, nt. English: eng, 
gr-r-r-r, bo-wo, ang, diddle, ing, bow-wow, th, udn, pop-pa- 
pa-ba, udu, bob-ba, um-go, good, moma (34:289). 

The order of development of the different sounds in the child 
as recorded by different observers shows some general agree- 
ment though there are variations in detail. According to 
Schultze's principle of least effort the vowels ought to develop 
in the following order : a, a, u, o, e, i, o, ii ; and the conso- 
nants thus : (i) p, b, m, f, w, d, n; (2) 1, s; (3) ch,j; (4)sch; 
(5) r; (6) ng, k, g. Preyer does not agree with this; he says 
he observed the vowels to appear in this order : u, a, a, o, o, 
ai, ao, i, e, ii, oeu (French) au, oi. He thinks that the sounds 
do not develop in the same order in all individuals and that the 
order of development is certainly not due to the influence of 
heredity (22:240). The consonants he observed in the follow- 
ing order: m, g, r, t, h, b, 1, n, k, j, d, p, w, s, z, f, q, x 
(22:74). He suggests that some of these sounds were un- 
doubtedly uttered sooner but that he failed to observe them. 

Sigismund gives the following order (26:138): (i) vowels; 
a, a, u, ei, o, i. He says o, ii, and au are not spoken purely 
by children. (2) Consonants ; b, m, n, d, s, g, w ; f, ch, k are 
learned with some difficulty, and 1, sch, and r, are the last to 
be spoken correctly. Lobisch gives the following order (11:18): 
m, b, p, am, ma, ba, pa (but not ab), d, t, 1, n, f, s, ch, g, k, 
Vierordt gives this order during the 3rd and 4th months: mam, 
amma, fu, pfu, ess, ang, angka, acha, erra, hab. Preyer did 
not hear pf and ss so early and doubts whether f can be pro- 
nounced distinctly owing to lack of teeth. Gutzmann has heard 
pf so early but the f was not pronounced as an adult would 
pronounce it. Tracy examined 700 cases of mispronunciation 
and on the basis of his investigation arranges the following 
order of diflBculty : b, p, m, h, a, w, o, k, d. q, n, t, f, e, j, s, 
ch, g, y, sh, V, th, 1, r. He found what per cent the number 



4 SPEElCH-DEVEIvOPMENT IN THE CHILD, 

of mispronunciations of a letter was of the total number of times 
the letter was found in the child's vocabulary (313:89). 

Oltuszewski (21:36) has observed the order of the conso- 
nants as follows: b, m, p, t, n, d, 1, c, dz', ch, k, j, s. z', f, w, 
g, z, r, t, sz, z, cz. That f, w, 1 appear much earlier with 
Preyer's child, he thinks, may be because there are more words 
in German that begin with those letters, or that thej^ appeared 
simply temporarily as transitionary noises (tjbergangsge- 
rausche). His observations, he says, contradict Prej'er's state- 
ment that all sounds used in later language develop so early, 
but that they confirm the physiological principle of Thausing's 
natural system of classification. Thausing, namely, holds 
(31:60) that beginning with a all simple sounds are formed by 
deadening the sound of a seven stages in three directions. His 
sy.stem is arranged in the form of an inverted cone as follows : 
m, b, p, f, w, u, o. A, e, i, j, ch, k, g, y; then from A he drops 
this series at right angles, 1, r, s, ss, t, d, n. The three letters 
equally distant from A have similar relations to A. Oltuszewski 
says, if we begin with a and narrow the vocal cavity forward 
we get o, u and all the consonants of Thausing's labial and 
dental series, but if we narrow the vocal cavity backward we 
get i, e, and the consonants k, g, ch, j. He then constructs a 
system similar to Thausing's but leans the dental series ob- 
liquely toward the labial series and adds to the former the 
Polish z-compounds not found in German nor English. 

From the abov^e we see that some letters generally appear 
early and others late; what is the cause of this? Schultze 
(25:27) explains the order of development by the following 
law : The sounds appear in a series which proceeds gradually 
from those which are made with the least to those which require 
the greatest physiological effort. He adds, however, in a foot- 
note that this series need not necessarily be the same with all 
peoples and all races, nor even with all families, owing to the 
influence of heredity. This he offers as an explanation for the 
fact that Preyer's observations do not verify this law. 

Gutzmann supports this law in the main but holds that there 
are manifold individual variations (i2:2or). He agrees to 
Preyer's objection that the degree of ph\'siological effort cannot 
be measured, but says that the stud}' of stammering children 
leads one to believe in the law (11:19). He points out that 
the muscle action in the three articulatory systems, lips, tongue 
and teeth, and palate increases in diSiculty in the order given. 
And, moreover, that those sounds which are the easiest for the 
child are most often repeated and are thus fixed in the motor 
speech memory, therefore they are more readily used when 
learning to speak (11:22). These dif&culties, he says, cannot 
be measured in a scientific way, but they can be noted in a 



SPEECH-DEVELOPMENT IN THE CHILD. 5 

general way by observing the muscle action. In speaking of the 
difficulty in the third articulatory system, he says: Evidently 
the muscle sense is less developed in the rear of the mouth than 
in the fore part. People can readily move their lips and the tip 
of their tongue into any desired position, but not so with the 
body of the tongue ; and their muscle sense fails completely 
when they try to move their soft palate without uttering a 
vocal (13:35). Franke (9:755) thinks the law is valid in the 
main during the period of voluntary imitation and decidedly 
valid in the combination of sounds. 

Dr. Hall (15:134) says: The child's linguistic development 
does not proceed from the easy to the hard, according to any 
adult standard, but the hard and often the very hard, may pre- 
cede the very easy. Rzesnitzek says Schultze's law cannot be 
accepted as a fact since by the law of senso-motor association 
difficult sounds may come early. Some sounds which the child 
makes playfully give it pleasure and it repeats them. When 
thus the attention is drawn toward the sounds the intensity of 
the sensation is increased, and this in turn sets free an increased 
amount of energy of the motor centres. If Schultze's theory 
were true, he says, it ought to hold in the instruction of deaf 
mutes, which it does not since some produce difficult sounds 
early, and moreover, all pupils would have to make the same 
progress, which they do not. However, he admits that labials 
and linguals are physiologically easier and adduces as proof 
that many primitive people have hardly any other sounds 
(24:8). Ament also thinks that a categorical statement like 
that of Schultze is not tenable. He says : The orderly suc- 
cession of the sounds is for the time being a secret which can 
only be solved by exact phonetic investigations in the future 
(2:58). He supports the following principle : The labials and 
dentals occur oftener than the gutturals among the first sounds 
of the child because they have a physiological preference. Ma, 
ba, pa are first because the organs that produce them are 
active in feeding. Moreover those animals that swallow their 
food without chewing and thus have a vigorous palate often cry 
with gutturals. Among birds, for instance, the cock crows 
"kikeriki," the hen says "gagag" the cuckoo "kuku," the 
raven "krahkrah." Those animals, on the other hand, that 
seize their food and chew it before swallowing often use labials 
in forming their cries. Among mammals, for instance, the dog 
says "wau wau," the sheep "bah, mah," the cow "muh," the 
cat "miau," etc. (1:55). 

Schultze, Preyer, Sigismund, Gutzmann and others ascribe 
the early appearance of labials and dentals partly to the prepa- 
ration the child gets through the sucking movements while 
nursing. Preyer furthermore says : The position of the human 



6 SPEECH-DEVELOPMENT IN THE CHILD. 

foetus is such that long before birth the hands easily may touch 
the lips, and that the swallowing of the nourishment causes it 
to flow over the edges of the lips and the tongue thus causing 
repeated excitement of the nerve endings of those organs. He 
however holds that the order of succession in which the sounds 
of speech are produced is different with different individuals, 
and consequently is not determined by the principle of least 
effort. It is dependent upon several factors — brain, teeth, size 
of the tongue, acuteness of hearing, motility etc. Only in the 
later intentional sound formations and attempts at speaking 
does that principle come under consideration (22:217). Oltus- 
zewski agrees with the above-named authors as to the im- 
portance of the exercise the lips and the tongue get in sucking, 
and adds that the gutturals and labio-dentals appear so late on 
account of the complicated mechanism involved in producing 
them. Sully also thinks that Schultze goes too far with his 
principle of least effort. He says, the very variability of this 
order in the case of different children, shows that there is no 
such simple correspondence as this (29:153). 

It has been noticed by many observers that some sounds are 
made early and later forgotten. From the order in which the 
letters were learned we see that some sounds uniformly appear 
later than others. The letter s is used late and has a tendency 
to remain imperfect often for years. Deaf mutes especially have 
trouble with it; though they learn it early they mUvSt be cor- 
rected again and again, whereas r, a very diflScult letter to learn, 
is not forgotten after the deaf mute child has once succeeded in 
pronouncing it. These facts Rzesnitzek takes as a basis for 
the following rule (24:28) : " The stronger the motor sensations 
necessary to produce a sound the less danger there is that the 
sound will be forgotten after it is once learned." This princi- 
ple, he thinks, explains Treitel's facts which he found in the 
Kindergartens of Berlin where out of 180 children examined 3-6 
years of age, 34.5% lisped. 

The law of Schultze has undoubtedly some validity during the 
period when the child imitates voluntarily but does probably 
not apply to the early reflex babble period. In early infancy the 
child makes many muscular movements reflexively which it is 
not able to co-ordinate for a definite purpose. Even some of 
the individual movements are late to come under the control ot 
the will. It is one thing to produce a movement accidentally 
while motor activitj^ runs riot, another thing to produce the 
same movement voluntarily. The same is true of the early 
speech sounds ; during the early reflex babble period when 
scunds are produced in profusion many sounds are accidentally 
uttered which it may be very difficult to produce voluntarily 
somewhat later. To determine the successive appearance of 



SPEECH-DEVELOPMENT IN THE CHILD. J 

the sounds of our language during this early period the child 
must be observed constantly and every sound recorded otherwise 
the record is not accurate because a sound or a group of sounds 
may appear one moment and not recur for some days or even 
weeks to come. The appearance of the later voluntary speech 
sounds is more easily recorded, and it is to these that many 
of the above records probably refer and it is to these that the 
principle of least effort somewhat applies. Anj' observations 
in this line should state definitely in which period they were 
made. The arguments advanced by the different writers for 
the preference the child gives to labials and dentals are quite 
plausible. 

2. Recapitulation Theory. Does the child repeat the 
history of the race? is a question which has interested psycholo- 
gists and educators for the last quarter of a century. Biology 
offers numerous facts which suggest that, both in the embry- 
onic stage and in childhood, the ontogenetic parallels the phy- 
logenetic development. These facts produced by biological 
investigations lead naturally to the question whether there is a 
similar psychic parallelism. Some of the ablest psychologists, 
both in this country and abroad, have worked in this field and 
sought to throw light on this question, the most prominent 
among them being Pres. Hall of Clark University. To what 
extent is there parallelism in the development of child lan- 
guage ? Let us see how different observers interpret the 
facts. 

Schultze was the first to suggest this parallelism between the 
language of the child and that of the race, but leaves the 
solution of the problem to the special investigator in lan- 
guages (25:41). Steinthal holds that there is no difference 
between the original creation of language, the learning of lan- 
guage by children and the language in daily use. Language 
is an ever creative activity and its origin is the same process as 
that which is taking place in its every-day use; that the lan- 
guage of the adult is different from that of the child and that of 
primitive man is due to the different view the adult of to-day 
has(27a:86). Preyer says, in the same way as the oldest 
language developed will the language of his time develop in 
every individual. Strieker says (28:68): "It is furthermore 
probable that human culture has had no special influence on 
the development of the very first psychic activities of the child. 
The care of children and sanitary conditions may have improved; 
but the first glimmerings of speech ideas (das erste Aufleuchten 
der Sprachvorstellungen ) has probably not been materially 
changed by culture since the time when man had as yet no ar- 
ticulate speech. " Again: "lam inclined to believe that the 
child in the first stages of development of its speech intellect. 



8 SPEECH-DEVEI<OPMENT IN THE CHILD, 

gives US a picture of a primitive condition of the speech of man. 
I am inclined to believe that the fact, that the first auditory 
sense impressions affect the muscles of the head and arm, is a 
rudiment of gesture language, the only language available to 
primitive man." And Techmer says there are analogies be- 
tween the phylo- and the ontogenetic development of language, 
but also differences due to an inheritance from all our ancestors 
that were able to speak, an inheritance to which primitive man 
was not subject (29a:2i5). Compayre says, the awkwardness 
in child-language corresponds to analogous phenomena in the 
history of languages. The child confuses c and t, and 1 and r ; 
it says "crop" for "trop," "cravailler" for "travailler," simi- 
larly the Latin "tremere" has become French "craindre," and 
according to Egger, he says, the ancient Egyptians did not 
distinguish between 1 and r and the Chinese to-day do not pro- 
nounce the r (4:248). Sully thinks that in the two original 
sources of child language, expression of states of feeling, desire, 
etc., and imitation of natural sounds we have the two commonly 
assigned origins of human language, and that to that extent 
there is a parallelism between the early evolution of language 
in the individual and in that of the race (29:144). Tracy 
(3ia:8i), in tabulating the 5,400 words in the vocabularies 
of 25 children, found that they contained 60% nouns, 20% 
verbs. Kirkpatrick (17) says the words in the English lan- 
guage contain 60% nouns, and 11 % verbs. The ratio of 
the nouns in the two tables is 60:60= i, but the ratio of the 
verbs is 20:11 = i.8i-t-. This, Tracy says, supports the view 
that the acquisition of language in the individual and in the 
race proceeds by similar stages and along similar lines, basing 
his view on Max MuUer's statement that the early Sanskrit 
roots of the Indo- Germanic languages all represent actions and 
not objects. Oltuszewski says (21:39) the gradual develop- 
ment of language in the child corresponds in a certain degree 
to the development of the same in the race. There are three 
stages of language development in the race which correspond 
to its mental development: (i) The original stage where each 
element represents a concept, the Chinese, for instance; (2) 
The aglutition languages which express a concept b)' means of 
circumlocution in which sensuous representations are needed; 
(3) Inflected languages. The child, he says, at first has only 
general ideas which it expresses by a word or series of words 
without any grammatical order, like the Chinese do. The 
aglutition period we do not find in the child because it lives in 
an environment of inflected speech, and therefore immediately 
passes over to the third stage. 

Gutzmann says, the paralleli.sm between child language and 
the language of primitive people needs no further proof ( 13:29). 



SPEECH-DEVELOPMENT IN THE CHILD. 9 

The cause of this parallelism as to sounds he bases on the theory 
of least eflfort advanced by Schultze. The sounds produced by 
the root of the tongue and the rear palate are the latest to be 
learned by the child and are absent or rare among primitive 
people — such are k, g, and ng. The k, he says, was intro- 
duced only recently among the Samoese, and they made the 
same substitutions according to Pratt's grammar of the Samoese 
language, that our children do — they interchange t and k, and 
n and ng. Moreover, the child during its first sound period 
(Periode der Urlaute) produces vomitive sounds, made by 
pressing the base of the tongue against the rear palate, sounds 
which have become fixed in a large group of culture languages 
in western Asia, and also the so-called "Schnalzlaute," cluck- 
like sounds, found among the Hottentots but in no culture lan- 
guage. This parallelism, he says, gives us a clear view into 
the ontogenetic and phylogenetic development of human 
speech. 

Ament says that the old original "Sprachgeist" is at work 
when the child learns its mother tongue (2:40). He finds 
that the most common and most pregnant phenomena of child 
language also play an important role in the development of 
human language in general. "The laws of sound in child lan- 
guage have been active in the historical development of our 
language. In word-formations through invention, through imi- 
tation of words of the mother tongue under the influence of 
elision, insertion, substitution, transposition, metathesis, pro- 
lepsis and metalepsis of sounds and syllables, through deri- 
vation, composition, contamination, and etymology, the in- 
vestigator finds nothing but old acquaintances; word formations 
by analogy give the key to the laws of form in the 'Volksspra- 
chen,' and sentence structure reveals the different degrees of 
word-sentence, sentence with and without flexion as original 
states of the isolating and inflecting languages. Moreover, the 
grammatical as well as the logical development show distinct 
parallelism." Thus he concludes that the ontogenetic is a brief 
repetition of the phylogenetic development, but that there are 
certain deviations (called Cenogenesis by Hackel) which are 
caused by a shortening of the process and by later influences. 
In explaining this theory he says, we must assume that the in- 
herited speech mechanism of the child corresponds more to a 
primitive state of development of the human race than to the 
state of development of his parents. Therefore the spontaneous 
word formations are similar to those of primitive people, and his 
imitated word formations similar to those produced by the race 
within historic times (1:84). He considers the biogenetic law 
of language as firmly established as that of embryology (2:42). 

Dr. Hall says (15:133): The individual child may epitomize 



lO SPEECH-DEVELOPMENT IN THE CHILD. 

in its Stages of development the history of the race in speech, 
as in so many other respects ontogenesis summarizes philo- 
genesis, but we can never know how far this is the case because 
the race history in this respect can never be written. Franke 
(9:773) says, Even though the development of language in the 
race and in the child is quite similar, with only different ex- 
ternal objects to excite speech activity, yet we must assume 
that some sound formations appear comparatively earlj^ with 
the child due to their importance and to a greater inherited 
speech capacity; and that in primitive man sound development 
was farther behind psychic development than in the child. Psy- 
chically primitive man may have been on the plane of the year- 
old child, but as to sounds he certainly stood lower. 

Wundt says that in the development of sounds in the child 
there is an approximate repetition of the general development 
of sounds only up to the point where language really begins. 
It holds true during the stage of inarticulate cries and the stage 
of articulate expressions of feeling to which no idea is attached, 
but not beyond that. Similarities like those pointed out by 
Gutzmann, between the language of the child and that of the 
Samoese, he says are not in point, because those people have, 
it seems, themselves developed considerably, since they for- 
merly, in all probability, had a much fuller system of sounds. 
Moreover, these sound simplifications as they are found in lan- 
guage development in the race can be explained by certain 
psycho-physical conditions, and if there are some parallelisms 
between child language and the language of primitive people it 
lies in the domain of word and sentence structure, and is ex- 
plained not by a "biogenetic law" but by the general peculiari- 
ties of an undeveloped con.sciousness (34:296). Ament replies 
to this that nobody doubts that it is due to an undeveloped con- 
sciousness but adds, "Hatten aber die Thatsachen damit einen 
Namen? Gerwiss nicht" (1:85). 

That there is a certain parallelism between the language ot 
the child and that of primitive people no one denies, but to 
demonstrate whether this is due to a biogentic law or not is a 
difl&cult problem, since, as Dr. Hall says, the race history in 
this respect can never be written. It is not only impossible to 
produce a complete history of the culture languages, but it is 
equally impossible to establish the changes that the languages 
of primitive people have undergone in their development. 
Ament and Wundt seem to represent the two poles in this 
discussion, and yet they are not as far apart as one would 
at first think. It would seem that Ament's construction of the 
biogenetic law does not differ very much from Wundt's "unde- 
veloped consciousness. ' ' And when Ament holds that Wundt 
explains nothing with his term it devolves upon the former to 



SPEECH-DEVELOPMENT IN THE CHILD. II 

set forth clearly which of the two terms is the most luminous. 
Comparative studies in this field can but be very fruitful for 
the psychology of language. 

3. Invention. Does the child in its early language de- 
velopment invent words ? A number of observers record words 
which they consider original with the child. Taine, for ex- 
ample, gives the following: koko = hen, oua-oua = dog, ham = 
food, tem = give, take; and saj'S originality and invention 
are so strong in a child that if it learns our language from 
us we learn its from the child (30:257). In the ca.se of the 
word ham he thinks both sound and sense were invented. Dar- 
win records mum ^ food (5:293). K. C. Moore: lum = cat, 
bizz = her own shadow, bahdiz = a figure on the ceiling, 
alah r=a girl often seen; also the following, used once and then 
forgotten: babax = hinge, blebs = ledge on the piano, piece it 
=to break. Horatio Hale (14:286 flf.) among other cases re- 
ported a case of two twins who began to talk at the u.sual age but 
not their mother tongue. They refused to utter a syllable of 
English though a sister 5 years old tried to make them do so, 
and hence they could not be sent to school when the time came. 
He also quotes a case from Dr. E. R. Hun. A girl 2 years 
old used only the word papa and mamma, but from that time 
on she began to use a language of her own. Dr. Hun had 
compiled her vocabulary which consisted of 21 words. These 
were used in a great variety of acceptations, indicated by the 
order in which they were arranged, or by compounding them 
in various ways. Romanes quotes Hale's paper at some length 
in order to demonstrate some principles of language invention 
in children. Tracy (3ia:7i) and Rzesnitzek (24:17) on the 
testimony of the writers quoted above, believe that the child 
invents words. Rzesnitzek says, however, whatever efforts a 
child may make to invent a language it is soon checked in its 
efforts by being urged to accept the language of its environ- 
ment. Ivindner's boy in the first month of the second year gave 
a long drawn out m when he heard the noise of a passing 
wagon. This Lindner suggests may mean, "There comes a 
wagon" or some such idea, and adds that this is an evidence 
that the boy has learned that his voice may be used to communi- 
cate inner states, though it takes one initiated to understand 
his expressions (18:24). 

More recently Ament thinks that one of the girls he observed 
invented ' 'adi' ' = cake. He considers spontaneity a very im- 
portant element in the child's learning to talk, and says (2:38) 
the child, not the environment, is the creator of the child's 
language, onomatopoea being the connecting link between 
originality and imitation (2:63). Stumpf thinks that in gen- 
eral one cannot deny that within certain limits a child may 



12 SPEECH-DEVELOPMENT IN THE CHILD. 

invent speech formations, but not in the early stages of develop- 
ment (27:422). He says his boy, who was very slow in learn- 
ing to talk, was very independent in forming compounds and 
gives a number of illustrations of which I shall give a few: 
"wausch-kap" = messer (Fleisch-kaput), "wausch-hopa" = 
Gabel (Fleischaufnehmen), "hotopapn"=Milchwagen (Pferde 
essen), "lal-bich" = Briefumschlag but "bich-lal" = Brief- 
marke, etc., (27.432). He thinks that the child in its anxiety 
to express its ideas may, as early as the second and third year, 
be led into original language attempts which are riddles rather 
than explanations to the adult — just as an adult in a foreign 
land amongst strangers sometimes coins words that only arouse 
an ignorant wonder in the person addressed. On the whole, 
however, he agrees with Wundt in his criticism of the "inex- 
plicable word formations" reported by Mrs. K. C. Moore and 
others, except the paper by Mr. Hale, which, he says, is not 
quite clear to him and is not free from objections, but he would 
not, like Wundt, place it e7i bloc in the domain of fable (27:446). 
Sully thinks that children if left alone would undoubtedly be 
able to invent signs, and instead of signs they might use 
sounds. The child gives certain vocal reactions to certain 
mental states, when these reactions are recognized by others 
they tend to become fixed as linguistic signs — such are "mum" 
and "ham" reported by Darwin and Taine respectively. The 
cases reported by Hale, he thinks, testify to the originality of 
the child in the field of linguistics, but adds that the effect of 
education is absent in none of those cases (29:138-144). Com- 
payre after quoting Rousseau, Maine de Biran, Lemoine, Egger, 
and Taine, who believe in the child's inventive ability in the 
domain of language, points out the following three ways in 
which the expressive spontaneity of the child may manifest it- 
self, (i) The child furnishes the sound or the word, but the 
parents give meaning to it though it was uttered without any 
intention. (2) The child invents a word and at the same time 
gives it a meaning; this is the most curious, the rarest, and also 
the most disputed case. (3) Very often the parents furnish the 
words, but the infant who repeats them interprets them in his 
own manner and uses them with a new signification. Com- 
payre believes in the child's ability to invent as to the first and 
third case, but thinks it is difiicult to demonstrate whether the 
child can make a complete creation in language (4:234 ff. ) . To 
first see the connection between sound and meaning the help of 
the parents is perhaps necessary, but after the bridge has been 
once constructed the child may spontaneously attach meaning 
to sound with more or less originality. Franke (9:758) thinks 
creation without imitation in the development of child language 
is very rare and with many children it is not found at all. 



SPEECH-DEVELOPMENT IN THE CHILD. I3 

Preyer answers the question thus : "I have shown that the 
first firm association of an idea with a syllable or with a word- 
like combination of sjdlables, takes place exclusively through 
imitation; but a union of this sort being once established, the 
child then freely invents new combinations, although to a more 
limited extent than is commonly assumed. No one brings in- 
to the world a genius of such quality that it would be capable 
of inventing articulate speech. It is difficult enough to compre- 
hend that imitation suffices for a child to learn a language" 
(22:215). Wundt says, one can readily understand how 
mothers and nurses come to believe that the child quite early 
gives its attention toward inventing its language, but that it is 
surprising that almost all pedagogical and many psychological 
observers of child language hold the same view (34:273). In 
referring to the cases reported above he says that it is now im- 
possible to decide what was really original and what was due 
to environment, but that it is quite clear that many of these 
words either resemble some words in adult language or have 
been so common in child language from quite early times that 
they look very much like borrowed expressions. For example, 
"koko" resembles "coque," "tem" resembles "tiens, " "piece 
it" resembles "break to pieces; " and "ham" and "mum" may 
have been acquired from mother or nurse who often imitate the 
movements of eating before the child when they are about to 
feed it, and these words require the same movements. He 
furthermore thinks that words for which we have no immediate 
explanation should not be accepted unconditionally as inven- 
ted. His own child, for instance, used "guck" for "chair." 
This puzzled him till he found that the nurse had placed a cat 
on a chair and had pointed to it saying "guck" (see). The 
child had accepted the word as a name for the chair and later 
for the cat. He found no original word in the two children 
which he observed. He believes that the child's word forma- 
tions, probably without exception, come from its environment, 
and that the reported cases of invented words in the earlier 
literature should once for all be placed in the domain of fable. 
Since more definite details are lacking in these cases it is pos.si- 
ble that we are dealing with misinterpretations. He says, the 
child may, however, develop (not invent) some process of 
making known its ideas and feelings by means of sounds if a 
ready-made language did not anticipate it. If children were 
left to themselves and would hear no spoken word from outside 
it is to be supposed that they would develop, besides their 
gesture language a natural though probably imperfect speech. 
This, however, would take place much later and in a difierent 
manner from the cases reported (34:286). 

Meumann (20) says child language may be formed in six 



14 SPEECH-DEVEI^OPMKNT IN THE CHILD. 

different ways: (i) Words are heard incorrectly and hence mis- 
pronounced; (2) these mutilated words may be misapplied; (3) 
they may be used correctly but also extended to other objects; 
(4) ononiatopoetic words may be extended to other objects by 
association; (5) the children may form new compounds; (6) 
with their early babblings in connection with parts of words 
learned they may develop a peculiar mode of expression which 
they may use for years until their environment forces them to 
abandon it. Into this class he would place Stumpf 's boy and 
the cases reported by Hale. The above facts, he says, even the 
opponents of invention do not deny, and offers these expla- 
nations: All peculiarities of child language are due to the im- 
perfect development of the child, causing imperfect imitation. 
Even though some of its onomatopoetic expressions are new it 
has lieard similar designations hundreds of times since it first 
began to understand speech. The cases reported by Stumpf, 
Horatio Hale, K. C. Moore and others show only an acquired 
mode of language, the development of which deviates from 
that of the adult. He agrees with Wundt that invention is a 
bad term. Children have an inherited disposition to develop 
language, but the environment of adults anticipates these fac- 
tors of inheritance, and in this .sen.se, he agrees with Wundt, 
that the language development of children is premature. Idel- 
berger also denies that the child has the ability to create words 
without external influence. His conclusion is based on the 
observation of several children (16:289). 

It is quite evident that no child will invent its mother tongue 
as Preyer says, nor any perfect language of any kind, j^et we 
cannot deny a priori that the child's originality has anything 
to do with its language development. The .scientific experi- 
ment to determine the child's originality has not been made 
and cannot well be made as Sully says. To take a few occa- 
sional observations in this field and then theorize about them 
is unscientific. To arrive at only approximate conclusions in 
this matter the previous experience of the child should be accu- 
rately known, and even then it is diflScult to tell which 
experiences sink deep down into the child's nervous system 
and which pass by without leaving a noticeable impression. 
Observing a child a few hours a day is not sufficient; continu- 
ous observation is the only basis upon which a reasonably 
accurate explanation of the child's new words can be given. 
We need more, and more careful, observations before we can 
draw conclusions. Such cases as Hale reports cannot be ac- 
cepted as resting on a rigorous scientific basis, but rather than 
place them in the domain of fable, they should encourage us to 
more careful observation in this direction. Two children like 
Stumpf s boy growing up together might well, one can imagine, 



SPEECH-DEVELOPMENT IN THE CHILD, 1 5 

develop a form of communication which at first sight would 
seem fabulous. Wuudt's criticism of the reported cases of 
invention is undoubtedly in the right direction, but when he 
denies originality in the child altogether his conclusions have 
rather an a priori than an inductive basis. 

4, Word-meanings. The development of the word-mean- 
ing of the child is a subject beset with great difficulties. It is 
probably the most difficult problem in the speech development 
of the child. What meaning does the child attach to the first 
words it understands and the first words it utters, is a question 
as interesting as it is hard ; that it is not the adults meaning is 
quite evident. The child manifests an understanding of words 
at quite an early age. During the first few months, even, fne 
mother's voice may soothe the child when other voices fail. 
Here are probably the first beginnings of an understanding of 
the sounds of its environment. Somewhat later the child will 
react with the eyes or with the head to certain words, as, for 
example, Lindner's boy did when he looked at the clock at the 
word tidac (20 weeks), or Taine's boy who looked at a certain 
picture when asked : " Where is grandfather ?" What is the 
explanation of these facts? What goes on in the mind of the 
child ? Simply associations on the animal plane, or are there 
glimmerings of a higher psychic activity ? How about the 
first words of the child ? Are they on the most elementary as- 
sociation plane or do they represent crude concepts ? 

The schematic representations of the speech centres have 
been used in illustrating the learning of language by the child. 
According to these schemes the child develops a word-sound 
centre and a motor speech centre ; the connection of these two 
leads to meaningless imitations, and the connection of them 
with a higher ideation centre leads to intelligent imitation, and 
finally to original speech, etc. These schemes are very help- 
ful as illustrations — especially in the pathology of speech — but 
when applied to the learning of speech by children their very 
simplicity tends to lead to superficial assumptions. 

Sigismund (26:111) showed his boy a stufi'ed woodcock and 
said "bird." The child immediately looked toward an owl in 
another part of the room. This. Sigismund thinks, and 
Preyer agrees with him, indicates that the indefinite concept 
"bird" had arisen. Preyer says that even before the first 
attempts at speaking a concept-forming combination of memo- 
ry images regularly takes place (22:11). Oltuszewski thinks 
that the child forms general concepts even before the develop- 
ment of language, but that many of its generalizations are 
false. The rudiments of comparison manifest themselves as 
early as the 4th month, when the child shows fright at seeing 
a strange person (21:11). A ment says the child begins with a 



l6 SPEECH-DEVELOPMENT IN THE CHILD. 

kind of root form, called " Urbegriflf," which has germs of 
both of the later categories (individual and general). From 
this "Urbegriflf" it passes to the individual and then to the 
general concept. Later, however, the child may omit the 
"Urbegriff" and begin with the individual concept. (2:152). 
Gutzmann says with normal children the word-sound centre 
and its connection with concepts shows surprising development 
even at the end of the first year (11:32). Erdmann holds 
that during the period when the child learns to understand 
language it forms abstract, acoustic word-ideas based not only 
on what is concretely experienced but also on what is typically 
universal (8:384). 

Taine's child applied "cola" (chocolate) to sugar, tart, 
grape, peach, fig. Taine thinks that that is a case of sponta- 
neous generalization, the common element being pleasant taste, 
connected with a desire to experience it again. Compayre 
thinks the child's gross generalizations are due to poverty of 
language ; it is in the position of a man who has but one vessel 
out of which he must eat all the dishes of his meal. The 
child is, moreover, apt to seize upon puerile resemblances and 
superficial associations (4:246). Sully says a child has no 
clear grasp of what a grammarian calls a noun ; neither does a 
child go through a process of comparing, etc., when he widens 
the application of his terms ; he rather recognizes something 
like that which he has seen before without troubling to note 
the diflference. In applying the word star to candles, gas 
flames, etc., the same process is at work that led men to apply 
the word sun to centres of other systems (29:161). 

Wundt holds that in the first language activity of the child 
all logical concept-forming processes are absent. The child 
names only individual objects. If it seems to widen the appli- 
cation of its terms it is not due, he says, to a process of com- 
parison, but rather to the fact that it easily mistakes objects 
that have only a distant resemblance and that differences of size 
and distance play hardly anj' part at all. Moreover, he says, 
the same word may be accidentally associated with more than 
one object, as for instance the word quak may be associated 
with the duck or with the water. He admits that these asso- 
ciation processes are at the root of all concept-forming pro- 
cesses, but says the latter are entirely absent in early language 
development (34:284). Baldwin says children call all men 
papa and all food mik because they react to sensations and thus 
form tendencies to definite reaction which stand ' ' ready to go 
off " on any kind of stimulus which is locally near enough to 
discharge that way (3:326). Here he sees what he calls a 
"concept of the first degree." He S3ys the "general" or "ab- 
stract" is only "an attitude, an expectation, a motor ten- 
dency" (3:330). 



SPEECH-DEVEIvOPMENT IN THE CHILD. 1 7 

Meumann objects to the views of most of the other writers. 
He says the only correct method of interpreting child language 
consists in the observance of the following three principles: ( i) 
Unless there are special reasons to the contrary, the word- 
meanings and the psycho-physical processes that are active in 
producing them must be considered as simple as possible. (2) 
Where the word-meanings are not perfectly clear the general 
physical and mental development of the child must determine 
the points of view for interpretation. (3) When at all possi- 
ble, the child's words must be interpreted by means of later 
stages of development which can be observed better. That is, 
a process of getting word-meanings which can be proved to be 
absent in later stages must be absolutely excluded in earlier 
stages (20:4). 

He holds that the first word-meanings of the child are ex- 
clusively of an emotional or a volitional character. Its first 
words are desire words and feeling words, if they designate 
objects it is only a .secondary matter He objects to the view 
that the child in the period when it understands language but 
cannot speak, forms abstract ideas of meaning (Bedeutungs- 
vorstellungen) as Erdmann says. The first utterances of a 
child we cannot consider primitive enough, they are associa- 
tions of an elementary kind, without a shadow of logical 
activity (20:22). That Sigismund's child looked toward the 
owl when it saw a woodcock was because the perception of the 
woodcock and the owl were the same. The application of the 
word "cola" to sugar, cake, grapes, figs, etc., was no concep- 
tual generalization, as Taine would have it, but rather the 
child uttered a desire word for a definite desire aroused by the 
sight of those objects (20:36). He thinks the observations 
are too meagre to permit of an explanation of these processes 
in the child. 

Darwin reported to Romanes the case of a child who named 
a duck "quak." It later denoted the water, all birds, insects, 
floating substances, etc., with the same word. Rzesnitzek 
(24:18) explains this as an extension of the meaning of a 
word. Meumann (20:44) says it is simply a case of simulta- 
neous association — the apparent generalization exists only in 
the mind of the adult. 

Specially difficult Meumann considers the following cases: 
Tracy's boy (3ia:75) applied the word "do" (door) to every- 
thing that stopped up an opening or prevented an exit 
including the cork of a bottle, and the little table that fastened 
him in his high chair. Also the case reported to him by Pro- 
fessor Bovet of a child who used "mii" for taking off and put- 
ting on a lid, for the taking away and disappearance of things, 
etc. And also the case of Preyer's boy who used "atta" to 



l8 SPEECH-DEVELOPMENT IN THE CHILD. 

designate the disappearance of a person, the darkening of a 
lamp by means of a shade, the opening and closing of a door, 
the dropping of an object from the table, and the disappear- 
ance of objects in general. Tracy and Preyer would say that 
the child had formed a concept though it may not have a clear 
connotation; Meumann says the child has focused its atten- 
tion upon some common parts to the exclusion of others. If 
there are no other common factors there may be a common 
emotional effect that produces the same name. He says 
schematic plans according to which the word-meanings of the 
child must develop (Ament's for instance) are easily made, 
but they tell us only what we already know a priori after 
thinking about the subject (20:55). Idellerger in the main 
agrees with Meumann's criticisms and conclusions (16). 

That the child goes through a concept-forming process dur- 
ing its early language development, as Preyer and others sug- 
gest, is incredible. The child-mind does not follow the laws 
of thought of the well trained logician. Neither can Meu- 
mann's view that we must consider the psycho-physical pro- 
cesses of a child as simple as possible, be accepted to apply 
beyond the very first stages of language. It is always a valu- 
able principle to be used as a check in interpretation, but be- 
yond the earliest language period it should not be used as an 
absolute law. The child's extension of the application of 
names may occur in several ways, as has been suggested; it 
may be due to simple association, or to the child's focusing on 
some common characteristic which to the child is the whole 
object; it may be due to similar reactions set off by similar im- 
pressions or similar emotional effects, or due, as Sully suggests, 
to a general vague impression that two objects are alike — a pro- 
cess which we often find among adults when they, for instance, 
call every vehicle a wagon. Whatever interpretation is given 
to the facts should be based on most careful observations. 
Meumann's criticisms and interpretation, in the main, seem to 
be sound. 

When Wundt says the first word-meanings of the child are 
elementary association processes, which lie at the root of 
concept-forming processes, and Ament says they are "Urbe- 
griffe," which may later develop into individual and then 
into general concepts, one is at a loss to see the difference be- 
tween the two which Ament seems to find (1:68). He does 
not want to discard the word "Begriff" in naming these ele- 
mentary processes for fear, it seems, that the genetic principle 
is done violence thereb5^ but that fear is based on imagination 
rather than on fact. 



SPBBCH-DEVBLOPMENT IN THE CHILD. I9 

II. Pathology of Speech Development. 

Stammering. That the child often imitates sounds incor- 
rectly has been observed by every one who has given attention 
to the matter. He omits letters, substitutes one for another 
and even drops whole syllables. Diflferent explanations have 
been given for this defect. Paul thinks this may be caused by 
the nurses who reduce difficult words to make them easy for 
the child, or the child may simplify difficult sound combina- 
tions by omitting individual sounds, or by assimilation. — 
Schultze says (25:37 ff.) his observations lead him to formulate 
the following law: For every sound, vowel or consonant, that 
the child cannot produce it substitutes the one nearest related 
and produced with less physiological difficulty, and if it has 
not mastered the latter it omits it altogether. The following 
is Schultze' s table of consonants: 

Labials p b m f (v) w r (labial) 

Linguals t d n Is sch r (lingual) 

Gutturals kg ng ch j r (guttural) 

Vertically the difficulty increases throughout from labials to 
gutturals; horizontally, with labials and dentals it increases 
from left to right, with gutturals from right to left, if we omit 
guttural r. 

Vierordt agrees with Schultze's main theory (33:456). He 
says the child does not give its main attention to bringing the 
vocal organs into position, but rather to the sound it is going 
to imitate. In speaking, the position of the lips, the tongue, 
the soft palate, does not enter clearly into the consciousness of 
the child — ^just as is the case with adults who detect a slip of 
the tongue not through the motor sense but through the ear. 

Wundt ascribes a certain validity to Schultze's principle that 
the child substitutes labials and dentals for gutturals and pala- 
tals, i. e., that the point of occlusion moves from the rear for- 
ward. He, however, does not believe that the child substi- 
tutes because the sounds are either difficult or unknown .since 
even in the beginnings of imitating speech-movements it 
generally has control of all articulations. The two reasons 
why the child makes these changes are ( i ) the acoustic and 
the optic apperception of the sounds and the sound-movements 
are imperfect; (2) the sound-combinations which occur in a 
continuous discourse are difficult. These combinations (Con- 
tactwirkungen) lead to regressive and progressive assimila- 
tions of which the latter is much more common than the for- 
mer. The predominance of progressive assimilation is note- 
worthy, he says, because in the culture languages of indo- 
germanic and Semitic origin the reverse is true, whereas in 



20 SPEECH-DEVELOPMENT IN THE CHILD. 

Other languages, the altai-ural, for instance, progressive assimi- 
lation prevails as with the child (34:298 ff. ). 

Sully (29:152 ff. ), in speaking of omissions, substitutions, 
and insertions assumes that the child is unable to produce cer- 
tain sounds and that this defect is not due to a want of discrim- 
ination of sounds by the ear, but suggests that an explanation 
is rather a complex matter. "We must remember further," 
he says, "that it is one thing to carry out an articulatory 
movement as a child of nine months carries it out, impulsively, 
through some congenitally arranged mode of exciting the 
proper motor centre, another thing to carry it out volitionally, 
i. e., in order to produce a desired result." As to transforma- 
tion of sounds, or metathesis, he says, "the explanation seems 
to be that the right group of sounds may present itself to the 
speaker's consciousness without any apprehension of their tem- 
poral order," and adds, that perhaps quasi-esthetic preferences 
play a part here too. He suggests that these defects have an 
analogy to defective speech in adults, in so far as when a man 
is very tired he is subject to similar inversions of order, and 
concludes that the student of the early stages of language 
growth, might find many interesting parallels in these devel- 
opmental changes in children's articulations. 

Oltuszewski (21:33 ^0 thinks that physiological stammering 
is due to a lack of practice in the proper use of the articulatory 
organs and to the weakness of the auditory centre. The whole 
word must, namely, be held in memory until all of it is 
spoken, and in addition to this the articulatory expiration 
mechanism must be operated. These difficulties generally pass 
awaj^ in a short time, but if the child's speech is neglected, or 
if it has poor models to imitate or if its word memory weak- 
ens, they may remain and may become what in the pathologj' 
of speech is called "Stammeln." Ssikorski thinks that in the 
child we find two types of mind, one gives attention to the 
sounds and neglects the syllables and the other gives attention 
to the syllables and neglects the sounds, both of which may 
lead to stammering. Rzesnitzek thinks that if the child has 
not repeated a sound often it has no motor images. If such a 
sound occurs in a word to be imitated, the child either omits it 
or replaces it by some other sound since hearing alone is not 
sufficient to master it; thus stammering begins. The frequen- 
cy of lisping he ascribes to the fact that "s" is produced with 
hardly any motor and pressure sensations. 

Ament (1:59) objects to the word Stammeln as applied to 
the language of little children since it is a pathologic term. 
He uses the word W orUimgestaltungen by which he means any 
change that the words of the mother tongue undergo in the 
mouth of the child. He says these changes have an undenia- 



SPEECH -DEVELOPMENT IN THE CHILD. 21 

ble similarity with the slips of the tongue in speaking and 
reading observable in adults (2:65), He classes them under 
grammatical rubrics such as elision, insertion, substitution, 
transposition, metathesis, etc. He offers these explanations 
but does not consider them exhaustive: (i) Careless pronun- 
ciation by adults is carefully copied by the child. (2) That 
part of the word upon which the attention is fixed is held in 
memory and is reproduced. A prominent cause of metalepsis 
is the tendency of the vocal organs easily to resume a position 
they just have had in the same word, especially if the required 
positions would be difficult. (3) The insufficient develop- 
ment of the organs of hearing. (4) The incomplete develop- 
ment of the speech organs. He agrees with Wundt that the 
child may be able to produce all sounds individually but may 
not be able to make the changes in the vocal organs as quickly 
as is required to produce every individual sound in a sound 
group, and with Sully that it may be able to combine sounds 
according to its own choice, which it may not be able to com- 
bine into words. That the child substitutes t and d for k and 
g during the imitation period he says is not because he never 
has been able to pronounce those sounds, but because he has 
forgotten them since his early babble period (1.51), 

It is quite natural for the child to have imperfect articula- 
tion. Most of the studies in language development of the 
child confine themselves to the first three years of child life, 
but the child's language does not develop fully in three 
years; a large percent, of the children when they enter school 
have yet imperfect vocal speech. And even though the child 
has more or le.ss perfect articulation its oral language is usu- 
ally not absolutely established till about the time of puberty. 
That is, should deafness set in before pubert}' there is always 
danger that oral speech will disappear also. Kussmaul 
(67a:25g) says with deaf mutes the origin of the trouble can 
most often be traced to the first four years of life, less often to 
the years from 4-10, and only rarely to the years from 10-14. 
lyater deafness may injure oral speech but it cannot destroy the 
word-pictures entirely. We find similar conditions with regard 
to other brain functions. As early as 1838 Dr. G. Heermann 
concluded on the basis of an inductive study, that those who 
lose their sight before the age of 5-7 do not, in adult life, 
dream in visual terms. He also held that deafness before that 
time would carry with it mutism. Jastrow (65) found the 
same result as to visual dreams. If blindness sets in before 5, 
he says, the visual centre degenerates, if it sets in after 7 the 
sight-centre maintains its function. 

Treitel (87:578) says, the fact that so many who have speech 
defects can trace the trouble back to their earliest childhood 



22 speech-devei.opme;nt in the child. 

and can generally not assign a particular cause for their origin, 
points rather a priori to the conclusion that many of these dis- 
turbances have their origin in the development of the child's 
language. That lisping is so common among children in kin- 
dergartens, he thinks, is due to poor perception since s has the 
highest pitch of all letters (5,400-10,800 vibrationsper second). 
Even adults hard of hearing omit it and it is the letter most 
poorly transmitted by the telephone. The sounds that are 
omitted in earlier years he thinks later become stumbling 
blocks for stuttering. It is furthermore true that children hard 
of hearing do not distinctly differentiate related sounds, which 
often leads them to stammer. 

It is evident that in the speech development of the child 
are numerous anomalies of articulation which can as yet hardly 
be called speech defects, but rather incompleteness of language, 
as Preyer calls them, 5'et out of such anomalies there may de- 
velop a number of speech disturbances in later years. Gutz- 
mann thinks that stammering in adults can often be traced to 
bad training in early childhood. He says one may safely 
say "bowow" for dog and "hiihii" for horse in the earliest 
language period, without endangering later speech develop- 
ment, but during the sentence period of its language develop- 
ment the child should have good models to imitate (55a:52). 
It is undoubtedly true that if the child fails to learn a given 
sound in early childhood, the difficulty to master it increases 
with years. We all know how difficult it is for an adult to 
learn the correct pronunciation of a foreign language, and the 
sounds of the mother tongue which the child does not learn 
will be like the sounds of a foreign tongue to him later on. 

Stammering, though it may be quite normal with the child, 
is always a defect when found in the adult. As a defect it 
may have one of two causes: it may be either functional or 
organic. In functional stammering the articulation remains in 
an arrested state of development without any ascertainable 
organic causes. Liebmann says in most cases where the defect 
is functional the child learned to talk late. Organic stammer- 
ing is due to anatomic anomalies. There may be abnormali- 
ties in the lips, the teeth, the tongue, the jaws, the soft and 
the hard palates, the nasal and pharyngeal cavities, the larynx, 
the ear or any part of the auditory mechanism which renders 
the perception of sound indistinct. Stammering beyond the 
age of 5 or 6 is to be considered abnormal. 

Anomalies of the tongue are rare. In most cases where 
they occur they are caused by the removal of foreign growths, 
though in rare cases the frenum may be short or the tongue 
may be too thick. The hare lip does not play as large a role 
in stammering as it did formerly since most children undergo 



SPEECH-DEVELOPMENT IN THE CHILD. 23 

operations to ojrrect this anomaly in early infancy. But if the 
operation is not successfully made the lip often varies from the 
normal so much that articulation is interfered with. Anoma- 
lies of the teeth are much more common. If the upper inci- 
sors are absent d and t, if the lower, s and ss are imperfect. 
If au3' of the side teeth are absent there may be a lateral escape 
of breath when the s is articulated. If the incisors are too 
long the labials are often formed with the aid of the upper 
incisors instead of the upper lip. Similar diflSculties may arise 
when one or the other jaw is too long. Defects of the hard 
and the soft palates and of the nasal cavities are very common 
sources of defective speech. 

Stammering is .sometimes divided into the following divi- 
sions: Rhinolalia aperta — when the nasal cavity cannot be 
closed from the vocal cavity and all sounds are nasalized. 
It is caused by a cleft palate, syphilitic or tubercular ulcera- 
tions in the palate, obstructions to the movements of the soft 
palate, such as paralysis of the soft palate, or through disease or 
tumors which interfere with the movements of this organ. 
Rhinolalia clausa — when the nasal passages are closed so that 
no air can pass through and the resonance chambers of the nose 
cannot be u.sed. Sigmaiism when the difficulty is only with 
the s and sh sounds; Lambdacism when the 1, Rhotacism when 
the r, and Gamniacism when the gutturals, especially g, are mis- 
pronounced. Parasigmatism, Paralambdacism, Pararhotacism, 
and Paragammacisjn generally mean the inability to speak the 
respective letters and others are substituted. 

Berkhan (41) has found that stammering children often show 
similar defects in writing. In the written word or sentence 
the mistakes are similar to those in the spoken one. For ex- 
ample (oral), "Der vol hat ness" (Der vogel hat nest), (writ- 
ten) "Der Folet ei ness." In the case of half idiots he found 
no such similarity, the oral mistakes did not coincide with the 
written. Mielecke (77:104) sa5's there is a difference between 
oral and written stammering, though in the main they are sim- 
ilar. The oral stammerer's mistakes are constant, he misses 
the same sounds and sound-combinations at all times, whereas 
the script stammerer shows no constancy in his errors, the 
sound-combinations which he writes correctly at one time he 
misses at another. Neumann says (79:11, 6) stutterers and 
stammerers often either omit or write in a trembling hand the 
letters which give them difficulty in oral speech. 

Therapeutics. First of all the organic abnormalities must 
be remedied by surgical operations as far as possible and neces- 
sary. Even cleft palates can be operated so skillfully now, it 
seems, that obturators need be resorted to very rarely. The 
paralyzed soft palate must be restored; some use massage 



V 



24 SPEECH-DEVELOPMENT IN THE CHILD. 

and electricity. The above remedies belong to the physician 
and preferably to the specialist. Moreover, the pupil should 
study carefully the physiology of the alphabet. The physiol- 
ogy of each sound that is defective should be deraonslrated 
and explained to him. This can be done by a specially trained 
teacher. If the pupil cannot place his articulatory organs, not 
even with the aid of a mirror, they should, as far as possible, 
be placed in position for him. Stammering is absolutely cura- 
ble if not caused by incurable mental and physical defects. 

Analogous Defects. Meringer and Meyer (76) made many 
observations as to the lapses of normal, healthy adults, and 
found that r and 1 present special difficulties. This has its 
analogue in people that are mentally diseased, as they point 
out, but it also has its analogue in children who are learning 
to talk. It is well known that r words are much used to detect 
speech disturbances, and that r is a difficult letter for the child 
to learn. Bawden (39:32) says that the consonantal digraphs 
which the child learns last and which, according to I^iebmann 
(69:25), are the most difficult to the mentally defective child, are 
the most involved in the phenomena of lapses, e. g., sp, fl, bl, 
br, St, sm, qu, etc. Meringer and Meyer's classification of 
lapses corresponds with Ament's classification of children's 
speech defects. They think that nearly all our speech defects 
have their origin in the connecting activity (anreihenden 
Thatigkeit) of our intellect. Meringer says: "All sounds of 
the inner language are not of equal value. In uttering a 
sound those of equal value which one intends to speak are antici- 
pated, and those of equal value which one has just spoken 
reverberate (though somewhat weaker) so that these sounds 
may displace the one that was intended to be uttered." Baw- 
den (39:12) thinks that there is a similarity between lapses 
and functional aphasia — that both are due to a temporary 
exhaustion through an over-expenditure of nerve force. 

Striimpell (85:444) has found similar slips in the school 
work of children. He says, in a school reader the following 
series of words were found: Dorf Dorfer, diirftig, bediirftig, 
Wiirfel, wiirfeln, werfen, Ort, etc. It took the weakest boy 
in the class three minutes before he could say the word Ort^ 
due to the influence of the f in the preceding words Basing 
his view on I^ay's investigations (683:133) he thinks that in 
such lapses a motor cause must be considered; that the expla- 
nation of many defects in oral speech can be found in the 
intensity of the motor elements. The individual tries to keep 
the flow of the movement, whatever is not easily said or writ- 
ten is suppressed or changed so that difficulties are avoided, 
according to the principle of least physiological effort. 

Biirgerstein (45) found similar slips in children's calcula- 



SPEECH-DEVELOPMENT IN THE CHILD. 25 

tions. He concludes that the most common source of error 
was that an oft recurring figure in the fore part of a problem 
pressed itself into consciousness in a later part of the same 
problem. For example, in the problem: 4592083976x6= 
7462503856 the oft recurring 5 evidently led the child to figure 
5x9 instead of 6x9. Or in the problem: 892415x4=3754460 
the 6 in the product evidently led the child to use 6 as a multi- 
plier. In the addition problem . .6214-]-.. 8493 =:.. 687 the 
7 in the result probably replaced the 9 in the second col- 
umn. He also found that figures of similar forms were apt to 
be interchanged, 9 and o, 3 and 8 for instance. These slips 
are similar to the lapses in writing and speaking and it is prob- 
ably beyond question that many mistakes made by children 
in their school work are as much beyond their control as 
lapses are beyond the control of the adult. Striimpell goes so 
far as to say that these slight disturbances may be the signs or 
forerunners of serious, even pathologic conditions. 

Stuttering. Speech defects are probably as old as lan- 
guage itself, and as far back as we have any record of them they 
have been a subject of annoyance. For a discussion of the 
earlier literature on stuttering one is referred to the works of 
Ssikorski, Schulthess, Gutzmann and others; in this paper the 
attention will be focused mainly on what has been done within 
the last 15-20 years. 

Theories. As to the symptoms of stuttering there is a gen- 
eral consensus of opinion amongst the different authors, but as 
to the explanation of some of these symptoms some authors 
vary somewhat widely. Berkhan, Coen, Gutzmann, Ssikorski, 
Oltuszewski, Treitel believe rather that the inco-ordinated 
movements are involuntary, whereas Denhard, Heymann, 
Gruenbaum lean to the opposite view, and Liebmann stands 
midway between the two. Again, Denhardt makes the real 
root of the trouble psychic, and Treitel and Heymann prefer 
the same view, whereas Gutzmann lays very little stress 
on the p.sychic element, and Berkhan, Coen, Gruen- 
baum, Oltuszewski and Ssikorski more or less agree with him. 
Liebmann does not agree to the extreme view of Denhardt who 
ascribes the chief trouble to the psyche, nor to the view of 
Gutzmann who thinks that the psychic phenomena are rather 
results and not causes of the trouble and are usually absent in 
childhood, but says the psychic factors are found with all stut- 
terers, even with very young ones. 

Kussmaul (67a) calls stuttering a spasmodic co-ordination 
neurosis which hinders the pronunciation of syllables in the 
beginning or in the middle of the sentence by spasmodic con- 
tractions at the point of occlusion when uttering consonants 
and vocals. There are three groups of muscle action in speak- 



26 .SPEECH- DEVEI^OPMENT IN THE CHILD, 

ing — expiratory, vocalizing, and articulatory — and in stuttering 
the regulating mechanism in the nerve centres which must 
harmonize these three actions is brought into disorder by pe- 
ripheral and more often by central excitation processes. Gutz- 
mann andSsikorski would agree with this in the main, but the 
former holds that the stutterer may have difficulty with indi- 
vidual letters as well as with syllables, and the latter that mere 
intention to speak may cause the cramps to set in. 

Denhardt (51) says stuttering is the inability under certain 
abnormal psychical conditions to utter speech sounds either 
individually as consonants or as vowels or in their combination 
into words, without repetition and without halting caused by 
too little or too much force, even though the sound or the 
word-picture is clearly and plainly before the mental eye of the 
stutterer. The real root of the disease is in the person's imag- 
ination or in his fear that he cannot utter certain sounds. The 
inco-ordinated movements mentioned by Kussmaul, he thinks, 
are voluntary. 

Wyllie (92) says stammering (stuttering) is due to a lack 
of co-ordination of the action of the larynx which produces 
vocal speech, and the oral mechanism which modifies the 
sounds of the larynx in tone and timbre. In a great majoritj^ 
of cases, he says, the common defect of stammering (stutter- 
ing) is due to a delayed action of the laryngeal mechanism. 

Liebmann (70) thinks that the primary source of the trouble 
is in the exaggeration of the consonant elements of the lan- 
guage, including the explosive sound of the vocal cords that 
precedes the utterance of .a vowel — the spiritus lenis of the 
Greeks. At first there are only slight involuntary inco-or- 
dinated speech movements, which through the exaggeration 
of the consonants cause an interruption in the continuity of 
speech; but through fright and embarrassment they become 
considerably intensified. The stutterer will even add volun- 
tary accessory movements which make his speech still worse. 
He thinks Gutzmann lays not enough and Denhardt too much 
stress on the psychic element. 

Gruenbaum (54) thinks stuttering is a speech disturbance 
caused by a kind of paralysis in the speech centre. The spas- 
modic contractions of the articulatory muscles as well as those 
that are not used in the formation of .speech are largely volun- 
tary and only to a small degree reflexive. All psychic pecu- 
liarities such as a feeling of fear, doubting one's ability to 
speak, weakness of will, etc., he, like Gutzmann, says are 
only natural resulting phenomena. He considers functional 
speechlessness and stuttering as different degrees of one and 
the same disease. 

Chervin holds aloof from theories, and prefers, in the present 



SPEECH-DEVELOPMENT IN THE CHILD. 27 

state of the science, to hold to the " terrain solicle " of clinical 
observation. 

Stammering and Stuttering were long considered one and 
the same thing, but now they are understood to be two entirely 
different defects. Schulthess, in 1830, was the first to point out 
definitely the difference though it had been suggested before 
that time. In this country the meaning of the two words is 
not carefully differentiated; stammering is used as a general 
term for defective speech, including stuttering, though Dr. 
Hunt, in England, as early as 1863, pointed out the difference, 
agreeing in the main with the German authorities. Gutz- 
mann states the difference clearly when he says that the char- 
acteristic of stuttering is spasms in one or all of the three 
groups of speech-muscles, which interrupt the flow of speech, 
but that these spasms may be accompanied by other accessory 
movements; and that stammering is a defect of pronunciation. 
The stammerer speaks fluently but mispronounces certain let- 
ters — he says, "Appe" for "Affe." "Taffee" for "Kaffee," etc. 

Though the two are entirely different defects they may, how- 
ever, be related. There are complications of stammering and 
stuttering where the former is the primary evil which causes 
the latter. If the stammering is cured the stuttering Vv'ill pass 
away at the same time. The difficulty, moreover, which the 
child meets in expressing certain sounds may give rise to the 
fear of speech, or fear of uttering certain sounds, so character- 
istic of stuttering. Treitel, furthermore, thinks that stutter- 
ing may lead to stammering. He cites the case of a young man 
22 years of age who sometimes stuttered two minutes before he 
could utter a word. Difficult sounds were often replaced by 
others as follows: Fuhrmacher for Uhrmacher, Fauna for 
Anna, sachen forlachen, Futschefor Kutsche, Same for Name. 
These substitutions, he says, were a result of stuttering, and 
is the only case in literature where stuttering caused stam- 
mering (86). 

Abulia is another functional disbturbance that should be dis- 
tinguished from stuttering. It is a weakness of will; the 
patient may know what he wishes to say and may be thorough- 
ly willing to say it but cannot — his will fails to act. It differs 
from stuttering in that there are not only no inco-ordinated 
speech movements, but there are no articulatory movements 
at all. 

AphtJiongia has some symptoms that make it seem similar to 
stuttering. It is a spasmodic contraction of the muscles in the 
hypoglossis region, which sets in at every attempt to speak 
and makes speech impossible. It is a very rare disease, only a 
few cases being recorded in literature. 

Blustering, or over-hurried speaking, though it may have 



28 SPEECH-DEVELOPMENT IN THE CHILD. 

some similarity with stuttering, is a different disturbance. 
Lapses are very common with the blusterer. He swallows syl- 
lables and words and often gets into such confusion that total 
inhibition sets in. He may often repeat syllables in his haste 
but no spasms of the speech organs are present. His speech 
is never very intelligible whereas the stutterer speaks normal 
between his inhibitory spasms. The blusterer may prevent his 
inhibitions by speaking slowly, the stutterer not. Now and 
then it may happen that stuttering develops out of blustering, 
but such cases are rare. Moreover, the two defects may occur 
together, then the patient instead of talking normally between 
his stuttering spells over-hurries himself so that his speech is 
hardly if at all intelligible. 

Stuttering has some similarity with chorea or St. Vitus 
Dance, but there is always this characteristic difference, as 
Liebmann points out: stuttering with its accessory movements 
occurs only while the individual is speaking, whereas in chorea 
the muscular disturbance may occur at any time. 

Etiology. The causes that bring about stuttering may be 
divided into the more remote or predisposing causes, and the 
more immediate causes, such as disease, fright, shock, etc. 
The former are the more important but most difficult to prove. 

That inheritance is a predisposing factor is not denied, but 
some authors consider it much more important than others. 
Gutzmann (59:302), for instance, says inheritance can only be 
accepted as a cause when we are certain that psychical infec- 
tion, i. e., imitation in the family, can be excluded, though he 
admits (12:212) that in the case children imitate the stuttering 
of the parents there is probably an inherited weakness (Min- 
derwerthigkeit) because some children of the same family will 
imitate and others not. ■ He cites a case (11:179) where the 
teacher had one stutterer among 60 pupils at the beginning of 
the year and five at the end. He thinks that the parents often 
wrongly accuse the school as the originof their children's stut- 
tering, but admits that probably 50% of those accusations are 
true. He tabulated 300 cases in his polyclinic and found that 
in 114 cases stuttering had been in the family, but that in no 
case inheritance could be proved; the stuttering grew up with 
the speech development of the child. Baginsky agrees with 
Gutzmann in laying main stress on imitation. He thinks stut- 
terers should be excluded from school until cured or, at least, 
considerably improved. Chervin says inheritance is an unde- 
niable factor, but that imitation plays a very great role in the 
cause of stuttering. Liebmann agrees with the majority of 
authors that the real cause of stuttering is nervousness which 
is either inherited or acquired through severe injuries to the 
nervous system, such as disease, trauma, alcoholism either of 



SPEI^XH-DEVELOPMENT IN THE CHILD. 29 

the patient himself or of his parents, masturbation, etc. These 
last named factors, he says, often play only a secondary r61e 
in so far as they produce stuttering in connection with an hered- 
itary predisposition. Stuttering, he says, can, however, only 
be considered inherited when the patient has never heard any 
other member of the family stutter (70:3). 

Arndt (36:76) thinks that stuttering, like convulsibility in 
general, is mainly inherited. He does not think that imita- 
tion plays an important role since some children in a family 
where the parents stutter are not afflicted with the trouble, and 
some that do stutter get well without special treatment, 
whereas others do not get well, though nothing is left undone 
to help them. Denhardt, like Arndt, lays chief stress on in- 
heritance. Of 1,994 cases he found that 77>^% had inherited 
their stuttering. When we consider that Coen at one time 
found in only 26^% and at another in only 11% inheritance 
and that Berkhan found inheritance in only 18.7% of 209 
cases, Denhardt' s percentage seems rather high. He. how- 
ever, considers all cases inheritance where the recent ancestors 
stuttered, without making any allowance for psychic conta- 
gion. He says (51:93), if children imitated the stuttering of 
their parents they would stutter in the same way as the 
parents, just as children copy the peculiar dialects of their 
parents. He has, however, found no such similarity. His 
high percentage of inheritance, he says, is in harmony with 
the facts as they are found in the case of other psychical 
diseases. Gruenbaum agrees with Denhardt, and says if there 
is stuttering or if there are other nervous diseases in the family 
we may speak of an inherited disposition. 

Of 114 cases in his journal Ssikorski (84:218) found inher- 
itance in 73% of them. He says predisposing inheritance has 
four symptoms: i. stuttering in the family; 2. nervous dis- 
eases in the family; 3. physical signs of degeneration; 4. 
special peculiarities of character — such as bashfulness, impres- 
sionability, etc., — characteristics which often manifest them- 
selves in early childhood. He does not think that these 
peculiarities are a result of stuttering, since those who stutter 
as a result of fright exclusiv'ely are entirely free from them. 

Mygind's investigations (78) show, as he points out, that 
inheritance plays a role in stuttering, yet he admits that 
psychic contagion often enters in as a factor, since children 
very readily imitate peculiarities of speech; 13% of his 200 
cases were reported to have acquired their trouble by associat- 
ing with stutterers, 42% had relatives that stuttered to the 
number of 124, 62 of which were brothers and sisters and 31 
fathers of patients. Of the fathers 1 1 had stuttered only in 
childhood. Idiocy was not found among the relatives more 



30 SPEECH-DEVELOPMENT IN THE CHILD. 

often than usual. 32 cases, 16% (in two instances there were 
two from one family), had relatives to the number of 36 who 
suffered or had suffered with epilepsy or similar convulsions, 
and 22 cases, 11% (including two of the above 32), had lost a 
brother or .sister through some form of convulsion, all of which 
would indicate that there is .some kind of connection between 
convulsions in childhood and stuttering. 58 cases, 29%, had 
relatives suffering with nervousness, neurasthenia, hysteria, 
sick headache, etc., to the number of 73, 46 of whom were 
mothers of patients. 15 cases, 7%, had relatives suffering with 
asthma, 7 of which were fathers of patients. In 5% of the 
cases alcoholism was in the family, in 7 cases it was the father 
who drank. In 10% intelligence was below normal, though 
idiots were excluded from the courses. 2.6% of the fathers 
were mentally deranged, whereas the normal for people of their 
age (20-40) is 0.2%. Of 162 who were examined on this 
point 11% wrote mirror script with the left hand. Though he 
admits that he has known many stutterers who had no neuro- 
pathic stigma and in whose families there was no nervous 
trouble, yet from the facts as he found them he classes stutter - 
tering among the neuropathic degenerations. His reasons he 
summarizes as follows: i. Neuropathic diseases are frequent 
among the relatives of stutterers. 2. Stutterers have some 
neuropathic stigma. 3. Stuttering, like most neuropathic dis- 
eases, (a) confines itself .somewhat to one sex and to certain 
age periods; (b) its immediate causes are less important than 
the more remote ones; (c) it is a functional disturbance of the 
nervous system though its pathologic — anatomic basis is not 
known. 

Oltuszewski al.so uses inheritance in the wider sense, and 
classes here all cases (i) where father and mother and the 
nearest relatives stutter; (2) where there were no other causes 
besides nervous diseases in the family, such as insanity, neuras- 
thenia, hysteria or any form of nervous degeneration; (3) where, 
notwithstanding other causes, heredity could be proven. In the 
nature of predisposing elements he considers inheritance and 
age as the most important causes (cf. his age table on p. 359). 
From 1 894- 1 899 he gives a careful record of 535 stutterers who 
attended his polyclinic. Among them he found 229 cases of 
inheritance and 30 cases of imitation, and in 169 cases the 
cause was unknowm. Imitation and fright, he thinks, are mostly 
important factors in connection with inheritance only, for 
stuttering he says, is a functional neurosis like hysteria, neu- 
rasthenia, etc. (80:1894, PP71). 

The more immediate causes that may produce stuttering are 
infectious diseases, shock, trauma, fear, etc. A blow on the 
head may sometimes produce a temporary speechlessness which 



SPEECH-DEVELOPMENT IN THE CHILD. 3I 

gives way to stuttering. Agonizing fright is known to cause 
stuttering. Disturbances in the digestive organs, interference 
with the blood supply to the brain, adenoid growths, or any- 
thing that disturbs the rather easily affected nervous equilib- 
rium of the child are favorable conditions for the disturbance 
to set in. Prolonged costiveness is a very common complaint 
among stutterers and generally aggravates the speech dis- 
turbance. 

Ssikorski thinks that fright is the most dangerous of the im- 
mediate causes. Out of a total of 167 cases he found 40 due 
to immediate causes, and of these 27, 67.5% were caused by 
fright, and of another 102 cases due to immediate causes 
reported by the physicians of military schools, 71.57% ^'e^'^ 
caused by fright. " Trauma, he found the next most important. 
Oltuszewski's table of immediate causes is as follows: Too 
rapid speech 18, brain disease 2, Imitation 30, Fright 23, In- 
fectious disease 10, Constitutional disease 6, Injury 47, out of 
a total of 535. 

Of Mygind's 200 cases 29% were brought about by the more 
immediate causes. His tables of infectious disease is as fol- 
lows: Measles 6, pneumonia 3, scarlet 4, whooping cough 2, 
diphtheria 2, mumps i, cerebro-spinal fever i. Only 2% were 
caused by trauma. 41 of Gutzmann's 300 cases were caused 
by disease as follows: ' Diphtheria 18, measles 14, scarlet 5, 
influenza 3, typhus i (11:183). 

That obstructions in the nasal passages affect respiration and 
speech is quite well known, but to what extent they rnay bring 
about speech defects is a question on which opinions differ. It 
is quite evident that they may produce stammering, but some 
authorities would say that they are of little importance in the 
etiology of stuttering. Gutzmann believes that they are pre- 
disposing conditions. In 33% of the patients he has met in 
his extensive practice he has found adenoid growths of a high 
degree (59:226). lyiebmann thinks they may be influential in 
connection with other causes to bring about stuttering. 
Dr. Bresgen thinks that at the bottom of most speech- detects 
there is a diseased condition of the nasal passages, since most 
of them begin in early childhood. The swellings in the nasal 
passages produce "speech-laziness" (44:209). They do not 
only offer resistance to the sound waves which are to pass 
through but they render less easy the movements of many mus- 
cles that are called into activity for phonation and articulation 
(43:99)- These difficulties, he says, lead the child to call 
other muscles into requisition. By doing this continually the 
child finally not only calls these muscles into activity but 
throws them into a spasmodic condition. This muscular activ- 
ity naturallv means a faulty activity in the nerve centres and 



32 SPEECH-DEVELOPMENT IN THE CHILD. 

nerve tracts, and brings about a morbid condition of the speech 
centres in the brain. Thus, he holds, the faulty movements 
of respiration and articulation which lie at the root of stutter- 
ing are in their turn caused bj^ a morbid condition of the nasal 
passages. 

Mygind found adenoid growths in 39% of his 200 cases, 
whereas another Danish observer found only 18% among the 
school children he examined. Kafemann and Winckler found 
among stutterers a higher percentage of adenoid growths than 
among children in general and think they should be remedied 
in order to facilitate the cure of speech defects. Gutzmann 
(57) has in a few cases found temporary relapses in stuttering 
upon artificial closing of the nasal passages, and Kafemann 
(67) has demonstrated experimentally that the ability to do 
mental work is lessened when the nose is clogged and increases 
when the nasal passage is opened. To what extent these ob- 
structions have a causal connection with stuttering may be dif- 
ficult to determine, but it is evident that they are a disturbing 
factor even in normal speech and should receive careful consid- 
eration at the hands of a specialist in case of speech disturb- 
ances. In some instances speech defects, even stuttering, have 
disappeared by a simple removal of these growths and in 
other instances the cure was considerably expedited. More- 
over, these growths are detrimental to the mental and physical 
growth of the child and should be cured whether they cause 
stuttering or not. 

Masturbation is held by a number of writers to be a factor 
in stuttering. They found that vice with a surprisingly large 
number of stutterers, and say that it probably contributed to 
the origin of the trouble, especially since it is well known that 
this vice, when practiced in childhood, may severely injure the 
nervous system. Scrofula and rickets are considered by some 
as important etiological factors; they weaken the system of the 
child and thus make the conditions favorable for stuttering 
to set in. 

^^e. In most cases this disease takes its beginning in early 
childhood, very often so far back that no definite data can be 
obtained as to the first sign. Parents often do not recognize 
the first symptoms and the patient's memory does not reach 
back far enough to give reliable information. Denhardt 
(51:101) gives the age of beginning with 348 patients who 
attended his institute during several years. Stuttering had 
begun with 250 cases before school age and during school age 
(to the 14th year) with 94 cases. From statistics he gathered 
from some of the large cities of Germany he had data as to the 
time of beginning in 6,206 cases. 87.14% stuttered when they 
entered school and 12.86% began during school age. Of 



SPEECH-DEVEIvOPMENT IN THE CHILD. 33 

the latter nearly ^ began during the first school year and 
^ during the first three years; after the third year there is a 
rapid decrease to the 8th school year when he finds only 3 
cases. 

Hart well 'stables (60:8 8ff.), as to the percentage distribution 
of stutterers of each sex in the several school years, shows a 
marked increase in the primary school over the kindergarten. 
He also found that slight stuttering is most frequent at from 
7-10 and severe stuttering at from 11 -14. His figures also show 
that stuttering and specific intensity of life have some relation; 
that stuttering increases markedly in the year in which the 
body's tide of exuberant vitality begins to ebb, this is espe- 
cially true of the increase of stuttering at 13-14 and 15-16. 

Ssikorski says (84:188) stuttering is a chronic neurosis 
which generally appears during childhood, remains stubbornly 
during youth, but gradually wanes in later years; few mature 
men stutter, old men hardly ever. He took the census of stut- 
terers in a number of schools with a sum total of over 22,000 
pupils. His table shows that stuttering holds tenaciously dur- 
ing early adolescence, but recedes with increasing years. He 
also has a second table containing the record of 406 cases ot 
which he had definite data as to the beginning of the trouble. 
This table shows that during the second, third, and fourth 
years of life the tendency to acquire stuttering is greatest. 
During these years the trouble began with more than half of 
the 406 cases, but this tendency decreases after five. A ten- 
dency toward a natural cure, however, sets in much later, as 
the first table mentioned shows. The danger to acquire stut- 
tering after 14, according to his table, seems to be very small; 
almost nine-tenths of the 406 cases acquired stuttering before 
10. His highest per cents are at the ages of 13 and 15. 

Mygind found with his 200 cases the following data as to the 
age when stuttering begins: 33 cases began at the age of two, 
20 at three, 31 at four, 29 at five, 25 at six, 15 at seven, 19 at 
eight, 17 after eight, and in 11 cases the age could not be as- 
certained. We see that 42% stuttered at the a_^e of four. 
He says the great majority of cases that began to stutter dur- 
ing the third and fourth years were late in learning to talk. 
About 50% of the 200 cases began to talk after the second 
year and about 25% after the third year. Mygind does not 
think that late speech development and stuttering have a 
causal relation, but rather that they are phenomena of a com- 
mon cause. 

As to age when stuttering began Oltuszewski gives the fol- 
lowing data of his 535 cases: Unknown 16, since early child- 
hood 138, 7 at two, 50 at three, 67 at four, 64 at five, 47 at 
six, 32 at seven, 39 at eight, 16 at nine, 24 at ten, 6 at eleven, 



34 ' SPEECH-DEVEIvOPMENT IN THE CHILD, 

6 at twelve, 7 at thirteen, 2 at fourteen. 4 at fifteen, i at six- 
teen, I at seventeen, 2 at eighteen, 2 at nineteen, 2 at twenty- 
one, I at twenty-four, and i at forty -three. Of the 123 stut- 
terers who attended Gutzmann's polycHnic in 1898 and 1899, 
62% had acquired their trouble before the 5th year and 28% 
acquired it during the three years from 5-7. Chervin says 
stuttering usually begins between the ages of 3 and 7, and very 
rarely later than 10 or 12 (48a: 146). 

All authors agree that stuttering usually begins in early 
childhood, and that many predisposing elements are found in 
the speech development of the child. The child has not yet 
firmh- fixed all the muscular co-ordinations necessarj' to pro- 
duce speech and hence thej' may easily be influenced by physi- 
cal indispositions and psychical disturbances such as fear, em- 
barrassment, etc. Liebmaun (72:6) says this is especially true 
of children that learn to speak late. Gutzmann says ( 1 1 : 1 76 ff. ) 
through the awkwardness of the speech musculature the child 
often halts in its speaking and this halting may, by increasing, 
develop into an evil. The child's thoughts run ahead of its 
motor speech ability and it repeats the initial sound or sylla- 
ble. Thus, little by little, stuttering roots itself in the speech 
of the child. Liebmann (72:6) would agree to this, but 
would add that with some children the development of formal 
language is somewhat retarded; the}^ think slowly and express 
their thoughts onl}' with difiiculty. They hesitate and correct 
their speech and thus produce inco-ordinated speech move- 
ments which, by increasing in inten.sity, eventually develop 
into stuttering. 

Ssikorski (84:189) says precipitate speech is more often fol- 
lowed by stuttering than slow speech. He al.so holds that late 
speech development is apt to be followed by stuttering. He 
cites a case, one of his patients, a physician: he had not spoken 
up to his sixth year when his parents placed him in an institu- 
tion for the deaf and dumb. Here he soon learned to speak 
but stuttered. Another patient who had spoken .since his 
second year, suddenly became dumb at 3; at the end of 6 mos. 
his speech returned but he stuttered. 

Some authors consider second dentition and puberty two 
periods specially favorable to the development of stuttering. 
Kussmaul (67a:232) says stuttering may appear temporarily 
during second dentition or at the time of puberty, or it may in- 
crease during those periods if already present. Gutzmann 
would agree to this but would not say that stuttering beginning 
at this period is necessarily temporary. It is well known that 
puberty is a period of great psychical activity and therefore 
not surprising that it has a connection with stuttering. It is a 
matter of common ob.servation that this disease increases at 



SPEECH-DEVELOPMENT IN THE CHILD. 35 

this period. A. Gutzmanti says it sometimes appears at this 
period like lightning out of a clear sky. 

Mygind thinks that very early childhood, second dentition, 
and adolescence are periods when the child is speciall}^ subject 
to stuttering. Denhardt, on the other hand, thinks that second 
dentition has not as much influence as some think it has. He 
thinks that the absence of the upper incisors may cause those 
cases of stuttering which begin during this period. Baginsky 
(37:11,351) gives the ages when children are especially subject 
to stuttering as 7-8 and 12-14. Hartwell's statistics (60:87) 
indicate that the trouble is particularly frequent during .second 
dentition and at puberty. The percentage of stutterers for the 
difierent ages was carefully worked out with 9,312 school 
children in Wiesbaden and 7,000 in Gorlitz. Gutzmann 
(59:335) takes the curves thus obtained and compares them 
with the curves obtained from Hartwell's figures. The 
three curves show a remarkable similarity; they rise at 7-8, 
fall after 9 and again rise at the age of 12-14. When one con- 
siders that the first rise corresponds with the last period of rapid 
brain growth, and the second with puberty it seems evident 
that there is a causal connection between the.se phenomena. 
We also see that these curves are similar to the curves of 
growth in body w^eight and height. 

Though stuttering may retard a pupil in his school work, 
the theory that stutterers are mentally weak has not been 
proved. Denhardt says that statesmen, poets and artists are 
found among the stutterers, and in many of his cases a com- 
parison with individuals of the same rank with normal speech 
would often have proved favorable to the stutterer. Neither 
are all stutterers physically deficient even though heredity plays 
a very great role. A number of writers, for instance, found 
among their patients men of excellent physique. Kafemanu, 
however, replies to this that some of these men may not have 
been so robust in earl)' childhood. 

Some stutterers pay little attention to the impression their 
defect makes upon their environment, whereas, many of them 
are silent rather than expose themselves to ridicule. If they 
are sensitive they feel their disadvantage and the mockery to 
which they are subject so keenly that the joys of life have but 
little meaning to them; they retire into themselves, starve their 
ambitions, feel suspicious of their environment, and, though 
living in the midst of society, they starve for the want of it. 

Sex. All statistics on stuttering show that there is a great 
sex difference, there being many more male than female stut- 
terers. Denhardt, Ssikorski and Hartwell give the ratio as 
about 3:1, Baginsky 2:1. Gutzmann 2:1 for children but 9:1 
for adults and says with girls it is more apt to disappear than 



36 SPEECH -DEVELOPMENT IN THE CHILD, 

with boys. Chervin gives the ratio as io:i, but says in lisping 
the sex ratio is inversed (483:149,277). Berkhan says the dif- 
ferences are the same as with idiots, half-idiots and deaf mutes. 
Westergaard found the ratio to be 2.5:1.9, and Lindberg about 
3:1 amongst school children in Denmark, von Sarbo about 3:1 
in villages and in the country, and about 2:1 in towns and cities 
among school children in Hungary. My own investigations 
give the ratio about 3:1 for stuttering and about 2:1 for stam- 
mering. 

That this difference exists has been observed by all, at least 
modern writers, but the cause of this difference, an interesting 
and important question, has not been solved. Some of the 
earlj^ writers thought that the girls had their errors corrected 
by their mothers because they were in the house more, whereas 
boys played on the streets and were not subject to this correc- 
tion and they, moreover, had their speech spoiled by Latin and 
Greek in the school. Others believed, with Rousseau, that 
since it was woman's sphere to please by dancing and sinj^ing 
and conversation she had a better developed nervous system 
and had more fluent speech. Kussmaul, and others after him, 
think this diflfereuce is connected with the fact that women 
are in general more graceful in their movements and can move 
in society and converse fluently earlier than men. Ssikorski 
(84:208-9) thinks that according to his investigations this dif- 
ference has an hereditary explanation. He examined several 
ten thousand manuscripts of pupils and found that atactic 
handwriting occurred with boys 7-8 times as often as with 
girls. He furthermore found that among 2,492 boys and 5,640 
girls the percentage of left- handedness was twice as great 
among the boys as among the girls. These facts seem to show 
that there is a better hereditarily developed motor centre in 
the left hemisphere, since the oral speech centre and the motor 
centre for the right hand are located near together in this hem- 
isphere. Only on such hereditary basis, he says, can we ex- 
plain the fact that girls are less subject to stuttering at the age 
of 2-4. 

The fact that girls usually learn to talk earlier, as has been 
noted by many observers, seems to support the view that there 
is an inherited difference. Gutzmann gives the following ex- 
planations: In its earliest speech development the girl u^es 
its speech mechanism rather automaticalh- without calling the 
ideation centre into play, whereas the boy is more apt to attach 
an idea to what he says, even though it be false. Further- 
more, in childhood, male and female breathe in almost the same 
manner; after puberty, however, the abdominal type is more 
prominent with the male and the costal type with the female^ 

' This question is not settled, cf. Havelock Ellis, "Man and Woman," 
pp. 202-210. 



SPEECH-DEVELOPMENT IN THE CHII,D. 37 

Of the costal type we are more conscious and hence it is more 
directly under the control of the will, and since disturbances 
of breathing are an important factor in stuttering the connec- 
tion can be readily seen (59:324). Waldeyer (88), moreover, 
points out that though the entire musculature of woman is in- 
ferior to that of man, the tongue alone is an exception. It is 
not comparative!)' but absolutely stronger than that of man. 
Even though this organ is not as essential in the formation of 
speech as it was formerly supposed to be, the importance of a 
mobile tongue for fluent speech cannot be denied. Liebmann 
explains the sex difference simply by the fact that man's muscles 
are stronger than woman's, but that woman's muscle is more 
dexterous and graceful (70:4). Chervin says that at the age 
when stuttering begins girls' language and speech-mechanism 
is better developed, and that girls lead a calmer life than boys 
and thus avoid many accidents that lead to stuttering 
(48a:i49). 

Hysterical Stuttering. A special form of stuttering which 
appears in connection with hysteria and hysterical mutism is 
called hysterical stuttering. Charcot, who was the first to 
draw attention to hysterical mutism, was also the first to ob- 
serve that this disturbance is sometimes accompanied by a form 
of stuttering. He at first believed that hysterical stuttering was 
a kind of transition-stage from mutism to normal speech; later, 
however, he found that it may precede hysterical mutism and 
may pass over into mutism any moment. Ballet and Tissier 
(38), in 1890, believed that hysterical stuttering may appear as 
a symptom of hysteria independent of hysterical mutism, 
though they admit that it may be preceded by a short period 
of aphasia which may be easily overlooked. They believe that 
the chief cause lies in a disturbance of respiration. Pitres, in 
the same year, held that speech defects in many young people 
who are seemingly not neuropathic may be looked upon as 
symptoms of a latent hysteria. Chervin (48) objects to this 
view of Pitres, and also to the term hysterical stuttering, and 
insists on calling such speech defects simply complications of 
hysteria. Gutzmann considers Chervin's protest against the 
term hysterical stuttering useless since it cannot destroy the 
facts. 

Ballet and Tissier think the cause is peripheral; Charcot, the 
great master of the study of hysteria, Greidenberg, and Higier 
consider it a cortical disturbance. Mendel thinks it is caused 
by changes in the sub-cortical centres or in the connecting 
fibres (Leitungswegen), and Remak considers it an inhibition 
(Intentionshemmung). 

Periodic Stuttering. It has been observed that stuttering 
often varies in intensity. Nasal catarrh or any other acute 



38 SPEECH-DEVEIvOPMENT IN THE CHII,D. 

disturbance of the respiratory tract may increase the intensity 
considerably. Severe stutterers speak often quite normal dur- 
ing acute diseases, but the disturbance returns as the disease 
passes away. With some patients the disturbance is most in- 
tense in the spring and in the fall. Second dentition and 
puberty are periods when stuttering is more intense. With 
girls the intensity often increases during the menstrual flow, 
and some cases are on record where girls stutter during the 
menstrual period though they speak quite normal at other 
times. Cases are also on record where early stuttering recedes 
to such an extent that it occurs only during short periods in 
the .spring and in the fall — periods when in younger years it 
probably was most severe. 

Simulation. The question of simulating stuttering is of im- 
portance in such countries where all able-bodied men must 
serve in the army and where the stutterer is released from ser- 
vice since he cannot repeat his instructions promptly . A number 
of earlier writers discuss this question and many devices for the 
detection of simulation have been suggested, such as, starving 
the individual into telling the truth, narcotising him with alco- 
hol or chloroform on the supposition that with the stimulant 
the stuttering would disappear in the stupified condition 
whereas with the real stutterer it would increase. Other mod- 
ern and more humane methods are, taking the testimony of 
witnesses, examining the individual directly, or surprising him 
so that he forgets himself. This last named method sometimes 
leads to very ludicrous exposures (59 and 70). 

Distributioji. Chervin made a careful study of the military 
statistics of several countries of Europe and found these 
results: In France 7.5 per thousand were exempt from service 
on account of stuttering, in Switzerland 3.23. in England 2.87, 
in Austro-Hungary 2.2, in Belgium 2.1, in Italy .86, in Russia 
.19 per thousand (48a) . Ssikorski's Russian military statistics 
give a little over i per thousand, and among 835,389 recruits 
examined during the civil war in the United States 1.25 per 
thousand were exempted on account of stuttering. Ssikorski 
thinks that this difference may be due to linguistic and ethno- 
graphic differences. Chervin, on the other hand, says that 
even neighboring departments in France show great differ- 
ences, and that long and diflScult study have not given him the 
key to the mystery (48a:95). Gutzmann, taking the French 
statistics for the provinces which in 1871 became German, 
and the Russian statistics of the Baltic provinces, both of 
which had a considerable German population, he estimates 
that in Germany there would be 2 stutterers per thousand 
recruits. Official figures, he says, are not accessible. He 
agrees with the elder Chervin that climatic conditions are di- 



SPEECH-DEVELOPMEN'T IN THE CHILD. 39 

rectly connected with the frequency of stuttering among 
different races. Von Sarbo found in Hungary that the Hun- 
garians represent 78. 19% of the school population but furnished 
only 64% of the children with defective speech. 

Westergaard (89) took the statistics of 34,000 Danish school 
children and found 2.2% with speech defects but only .61% 
stuttered. He found that girls lisped as frequently as boys 
and nasalized more frequently. He also took the average age 
of all the children in the different grades and of the children 
with the different speech defects — each speech defect separatel)', 
and found that the average age in every case was higher with 
children that had speech defects. lyindberg (73) found in 
Denmark, outside of Copenhagen, among 212,000 children in 
the country .9% stutterers and .74% among 85,000 children 
in the towns. Von Sarbo found 1.02% stutterers among 231,- 
468 children in 53 towns and cities in Hungary. He found 
that lisping was more frequent among the girls. 37 % of the 
stutterers, he says, were hindered in their progress in school. 
Statistics taken in Hamburg in 1896 also indicate that stutter- 
ing retards intellectual development. 

I gathered statistics^ of 87,440 school children in this coun- 
try, 44,754 boys and 42,686 girls, from the following cities: 
Milwaukee 31,810, Cleveland 19,678, Louisville 14,865, Albany 
11,369, Springfield, Mass., 5,902, and Kansas City 3,816. Of 
these 2.46% had speech defects; .87% stuttered, and 1.59% 
had other defects of speech. 1.25% of all the boys stut- 
tered and .47% of the girls, making the ratio nearly 3:1. 
2.01% of all the boys stammered and 1.15% of the girls, 
making the ratio nearly 2:1. Of the four cities which are 
represented by over 10,000 children each, the percentage is as 
follows: Cleveland — stutter .5%, stammer .77%; Albany — 
stutter .66%, stammer 1.35%; Milwaukee — stutter 1%, stam- 
mer 1.25%; Louisville — stutter 1.08%, stammer 2.41%. 

The cases were distributed by age and grade as follows: 

Age 5 6 7 8 9 10 II 12 13 14 15 16 17 18 19 

Stutt. 5 45 loi 89 80 84 90 84 82 49 28 13 7 6 4 
Stamm. 41 193 221 181 148 144 121 132 86 67 31 9 

Grade i 234567891234 

Stutt. 142 128 III 119 86 69 53 28 4 12 3 II 3 
Stamm. 480 250 156 189 122 71 59 44 4 82 

We see that the tendency toward a natural cure is more man- 
ifest in stammering than in stuttering, a fact also noted by 

^For assistance in gathering these data I am indebted to the follow- 
ing city superintendents : T. M. Balliet, of Springfield, Mass. ; C. W. 
Cole, of Albany, N. Y. ; E- H. Mark, of Louisville, Ky. ; E. F. Monl- 
ton, of Cleveland, O. ; H. O. R. Siefert, of Milwaukee, Wis. ; and Asst. 
Supt. F. D. Tharpe, of Kansas City, Mo. 



40 SPEECH-DEVELOPMENT IN THE CHILD. 

Ssikorski. Whether there is an increase in speech defects from 
the kindergarten to the grades I had no data to prove; neither 
had I data to find the percentage of stutterers and stammerers 
in the different grades and at the different ages. As to the 
question whether the child with speech defects falls behind in 
the grades my results were negative, but my data were not 
full enough to make the results conclusive, since I had data 
only from Kansas City as to the ages of the children in the dif- 
ferent grades. 

The report of the Commissioner of Education for 1902 
(Vol. II, pp. 1641) gives the total school enrollment as 17,- 
460,000. Applying our percentages to this number we find 
about 152,000 stuttering and about 278,000 stammering 
school children. Adding to this 1.25 per thousand of the adult 
population, as shown by the military statistics, we have in 
this country about 500,000 people with defective speech, 
almost half of whom are stutterers. 

The careful studies of stuttering that have been made in Eu- 
rope by specialists is certainly in the right direction and their 
earnestness deserves to be emulated in this country. The same 
can hardly be said of the theories. A theory may be quite 
useful as a working hypothesis if it does not fix firmly definite 
lines of action as seems to be the case with some of these 
theories of stuttering. They ma}^ be divided into two general 
classes, nameljs the physiological and the psychical. Gutz- 
mann, Coen, Ssikorski and others see in stuttering a disturb- 
ance of the nerve mechanism, which ma)' as a result bring 
about certain psychic disturbances, such as depression, fear of 
speech, etc.; they emphasize the physiological side of the ques- 
tion. And since they hold that the disease has a neurological 
basis, their method is naturally on the same basis, therefore 
they give an elaborate series of exercises that build up and 
drill the nerve mechanism of speech. They place the whole 
psychology and pathology of stuttering on a physiological 
basis, in harmony probably with their general philosophical 
view. On the other hand, men like Denhardt take the oppo- 
site view. Their views rest on the basis that the nervous 
mechanism is a means of expressing psychical states and not 
he cause that produces them. Both views seem to rest on 
the promotor's general philosophy — on rather a priori concep- 
tions. If functional nerve disorders could be so easily ex- 
plained and classified under these conceptions, many now dif- 
ficult problems of the psychiatrist would be more easy of solu- 
tion. It would seem to be better to make our theories of stut- 
tering, and so our methods of curing it. more tentative until 
we have more light on the nature of functional nerve diseases. 
The etiology and psychology of stuttering must be carefully 



SPEECH-DEVELOPMENT IN THE CHILD. 41 

studied as has been done by several authors as is shown in 
this paper, and from these results we must work toward an 
explanation and a cure, and not make the symptoms and the 
methods fit certain preconceived ideas. With this spirit we 
would have fewer standardized methods and less self-satisfac- 
tion but better conditions of progress. 

Methods. It is quite probable that stuttering in many 
cases might be prevented by proper prophylactic measures. 
Proper precautionary measures should be taken not later than 
the first appearance of slight disturbances. . If the child's 
speech is too hurried, if its motor speech activit)'' runs ahead 
of its mental activity and it hesitates and repeats sounds and 
syllables it should be cautioned to modify its tempo and to 
know what it wants to say before speaking. It is a good gen- 
eral principle always to lead children to talk in a quiet undis- 
turbed manner. Above all is it necessary for parents and 
teachers to use patience with children that have defective 
speech. It is cruel to whip and scold them because, instead of 
remedying the evil, it makes it worse, and moreover, the child 
is not to blame for its trouble. The child should be treated 
sympathetically; should be helped by means of stories and 
conversations in the most simple and effective language. It 
should not be made to feel conscious of its speech by insisting 
on superfine "correctness." The child's attention should be 
drawn away from its defects; it should unconsciously be led 
into normal and fluent speech. Nothing should be done that 
excites fear or anxiety, or that in any way psychically disturbs 
the child. If there are any physical deficiencies they should 
be corrected under the direction of a physician. 

All writers agree that one cannot prescribe a method that 
■will apply to all cases. The modes of stuttering are so differ- 
ent that each case must be treated individually, and, hence, 
some writers do not give a general method at all, whereas 
others give a detailed method of breathing, vocal, and articula- 
tion exercises which is to be adapted to the individual cases. 
Among the latter we find Ssikorski, Coen, A. and H. Gutz- 
mann and others. Treitel lays little stress on breathing 
exercises, but uses the other two, and lyiebmann rejects them 
all three as not only useless but harmful. Denhardt lays main 
stress upon the psychical phase of the treatment, a phase also 
emphasized by L,iebmann; and Gruenbaum would strengthen 
the will by a change in the speech tempo and by vocal exer- 
cises. I shall present the methods under the following 
headings: i. Breathing exercises; 2. vocal and articulatory 
exercises; 3. medical treatment. 

I. Ssikorski (84) gives considerable attention to the breath- 
ing exercises, and divides them into three parts: simple, 



42 SPEECH-DEVELOPMENT IN THE CHILD. 

fractional, aud compound. Simple breathing consists in sim- 
ple inhalation and exhalation, and is represented thus | — , 

! [5-] , etc. The vertical line represents inhalation and 

the horizontal exhalation; the figures in brackets signify 
pauses in seconds. The patient should be drilled in extending the 
expiration. Fractional breathing is represented thus | [5] — 

— [5] — . etc. In this figure the inhalation 

consists of two parts, and the exhalation of five parts of various 
lengths; where no figures occur in the breaks there is to be no 
pause of any length but only a break in the air current. This 
exercise can be varied to suit the occasion. The aim is to 
cultivate abroken exhalation as it occurs during speaking. Com- 
pound breathing consists in alternating the first two kinds. 
After a few fractional inhalations and exhalations while speak- 
ing one usually breathes regularly a few times, either to 
facilitate the diffusion of gas or to take a rest, or both, and 
compound breathing exercises are a preparation for this. These 
breathing exercises are intended to bring breathing under the 
control of the will and prevent those breathing disturbances 
which appear in stuttering. It is moreover, possible, Ssikorski 
thinks, that the sucking action of the thorax regulates the flow 
of blood from the head, aud that, as Coen says, increased 
breathing strengthens the chemism of the blood, both of which 
processes have a beneficent effect on stuttering. During these 
exercises, he says, the patient should give careful attention to 
the muscle sensations and should try to produce them mentally. 

Coen (50) and Gutzmann (59), give extensive breathing 
exercises which do not vary very widely from those outlined 
above. Gutzmann, however, follows the breathing exercises 
given in D. G. M. Schreber's Zimmrergymnastik which he con- 
siders the best book of its kind published (trans, by C. R. 
Bardeen). H. Gutzmann, does not use divided, or fractional, 
inspiration. He would, however, give gymnastic drill in addi- 
tion to the breathing exercises, since that would not only exer- 
cise the general musculature of the body but would train the 
motor centres of the brain as well. All exercises must tend 
toward enabling the child to use its speech-mechanism nor- 
mally. Chervin also gives breathing exercises, and says the 
difficulties of respiration determine the treatment (483:226). 

2. After breathing has been mastered, vocal and articula- 
tory exercises are taken up. Ssikorski first teaches his patients 
to open and close the glottis. Then by means of the aspirate 
h one bridges over to whisper the vowels. The h is first 
given alone, then in connection with a (as in af) in a whisper, 
and then with sound. The h is a less perfect product than a 
pure vowel, and hence, is useful as a connecting link. Other 
vowels are then taken up. To the vocal drill he later adds 



SPEKCH-DEVKLOPMENT IN THE CHILD. 43 

articulatory exercises. Breathing must be carefully observed 
during these exercises. Then composite speech gymnastic is 
taken up in the following order: i. repeating after the 
teacher; 2. reading; 3. reproducing mentally what has been 
read, as an innervation exercise; 4. reciting what one has com- 
mitted to memory; 5. talking in a whisper; 6. talking aloud; 
7. exercise in modulating the voice while speaking or declaim- 
ing; 8. the patient tells orally what he has read, or retells 
what he has told before; 9. conversation. All exercises, he 
says, should be adapted to the individual and should begin 
with the least affected part of the speech mechanism, and grad- 
ually work toward a drill of the affected muscles. 

Gutzmaun, also begins with h, passes to whispered and 
then to voiced a (as in arm), all in one breath. Then he drills 
the vowels, whispered and voiced in continuous and fractional 
exhalation, passing from the easier to the more difficult. In 
continuous exhalation the voice should gradually swell to 
full volume. In passing to words and sentences the same 
principle is followed. Words with the letter a as initial are 
taken first; the vowel is begun softly and gradually increases 

in intensity, thus, | A. tern. Other vowels are drilled 

in like manner. The first sentences, which are taken up later, 
should begin with a word whose initial letter is a, and the 
words they contain should be spoken as if the}- were all sylla- 
bles of one word. 

In order that the stutterer may learn to control his articula- 
tory organs Gutzmaun teaches him the physiology of articula- 
tion with the aid of a mirror. He is placed before a mirror in 
which the different muscle actions are shown him. These ac- 
tions he is led to imitate by focusing his attention on them 
without thinking of speech, thus: b — bb — bbb — bbbb. 
The letters w, s, 1, r, m, n, j and sh (Germ, sch) may be drilled by 
drawing them long in order to accustom the articulatory organs 
to producing them with voice, thus: | 1 a. 

Before taking up fluent conversation the stutterer is given 
the following rules as a guide: i. Speak slowly and calmly. 
2. Always be sure that you know what you wish to say and 
how you want to say it. 3. Do not speak too loud nor in too 
low a tone. 4. Stand or sit straight and still while you speak. 
5. Take a short, deep breath before speaking a sentence. 6. 
Be sparing with your breath; hold it back rather than urge it 
forward. 7. Give prominence to the vocal position. 8. 
Focus the expiring air not on the consonants but on the 
vowels. 9. Do not use stress in the formation of sound. 

10. Begin the vowel with a soft and somewhat deep tone. 

11. Extend the first vowel in a sentence and combine all words 
as though the whole sentence were but one word. 12. Always 
speak plainly with a pure and melodious voice. 



44 SPEECH-DEVEI.OPMENT IN THE CHILD. 

As a first drill in independent speech the stutterer answers 
simple questions. Then he reads simple poetry, later prose, 
and answers questions on these selections. He must also con- 
stantly practice those expressions which he must use in his 
intercourse with other people. The psychic phenomena, he 
says, wull take care of themselves after the stutterer has con- 
fidence in his ability to speak, unless they are a disease in 
themselves, then special psychic treatment is required. 

Coen begins with a vocal drill. The vowel is drawn out as 
long as possible; then 2, 3, 4 and 5 vowels are sounded suc- 
cessively in one breath. Umlaute and diphthongs are treated 
in the same manner. In the word drill the sounds are intro- 
duced in the following order: i. vowels, umlante, diphthong; 
2. consonants: labials, labio-dentals, sibilants, labio-palatals, 
gutturals. Later, reading and conversation are taken up on 
similar lines as indicated above. 

Wyllie first informs the patient that his larynx is at fault; 
that he must pay no attention to his mouth but to his voice. 
He should read aloud at least 10 minutes ever}^ morning. He 
should know the physiology of the alphabet and have test 
sentences for the different letters of each stop position: First 
stop position, p, b, m, w, f, v, th, s, z; second, t, d, n, 1, r; 
third, k, g, ng, h, ch, r. He should note every word that 
gives him difficulty so that he may refer to the physiologic 
alphabet (92 : front.) and find the key to its pronunciation. 
He should not be permitted to speak with empty lungs. Dr. 
Makuen also would teach the stutterer the physiologic alpha- 
bet, and constructs one on the basis of Dr. Wyllie's (74:251), 
Bernard would have the patient repeat the alphabet at least a 
dozen times a day at the rate of one letter in two seconds. He 
asks his pupils to study the alphabet before a looking glass. 
His first exercise is the first 34 lines of "The Deserted Vil- 
lage," committed to memory'. He has 31 exercises in reading 
and reciting. 

Liebmaun uses no preliminar}^ exercises. He immediately 
begins with conversation; he has the patient speak with ex- 
tended vowels, and most of them, he says, in this way speak 
fluently at once, and immediately lose all fear of speaking. 
He praises his patient freely by way of encouragement, and 
thus restores his self-confidence. Chervin gives breathing, 
vocal and articulatory drill, but varies from the other authors 
in so far as he prescribes absolute silence, outside of the exercise 
hours, for the first week, to secure repose, and that the patient 
may forget his trouble (48a:23i). 

A. M. Bell, though he gives some attention to respiration, 
saysthe stutterer's "never-to-be-forgotten talisman is: Voice!" 
The letters which are special stumbling blocks, such as b, d. 



SPEECH-DEVELOPMENT IN THE CHIL.D. 45 

p, g, t, k, f, wh, th, s, sh, h, should be practiced with vowels, 
with the principle constantly before the mind that "«o mouth 
action must be allowed to interfere with the flow of throat- sound'' ^ 
(40:23). The tendency toward an upward pressure of the jaw 
should be controlled, and the head should be held firmly on the 
neck, but not with stiffness that would interfere with free mo- 
tion. The spasmodic actions will invariably pass away when 
breathing is relieved, he says. 

When one looks over the detailed methods one immediately 
sees that they are carefully graded, passing from the funda- 
mental to the accessory, and from the simple to the more com- 
plex ; yet one can but conclude that they are conventional. It is 
true that all these methods lead to more or less successful 
results; furthermore, no one can deny the value of drill in 
proper breathing and no doubt many stutterers are benefited 
thereby, just as many people with normal speech would be; 
but, since it is proved that stuttering can be cured without such 
drill, it seems rather dogmatic to prescribe it in a stereotyped 
manner. Neither need one categorically class all such exer- 
cises as useless, since some stutterers may be in need of them. 
Moreover, we always have a tendency to follow tradition and 
this tendency manifests itself in the schematic breathing, vocal, 
and articulatory exercises so much in vogue in Europe and 
which are being introduced into other coutitries. even into 
Japan (52). Are these exercises an essential part of the thera- 
peutics of stuttering ? is at least an open question. Though 
the promoters of these didactic systems all insist more or less on 
individual treatment, yet their .systems are such that they have 
a tendency to methodize the treatment to a uniform standard, 
whereas the nature of the disease urg€;ntly demands individual 
treatment. A breaking away from these forms as, for instance, 
lyiebmann has done, is a health}' sign and shows that possibili- 
ties are being explored. The methods used by Wyllie and 
Makuen seem better adapted to stammering than to stuttering. 

It is the prevailing opinion among the authorities referred to 
in this paper, that the speech specialist should be a physician. 
One readily sees the reason for this view when one considers 
that so many physical anomalies are vitally connected with 
speech disturbances. However, a better plan would be that of 
Dr. Makuen, who holds that it takes a specialist, assisted by a 
special teacher. In that way we are more apt to have the 
clinical and the didactic features at their best. Furthermore, 
both physician and teacher should have a thorough knowledge 
of the physiology of speech, and since stuttering is often 
accompanied by psychic depression they should have, at least, 
an elementary knowledge of that chapter of morbid psychol- 
ogy. 



46 SPEECH-DEVELOPMENT IN THE CHILD. 

3. Medical Treatment. Pharmaceutical treatment for stut- 
tering has been recommended since the time of Hippokrates. 
At the present time general prescriptions for stuttering are not 
used. Ssikorski insists on these points: i. The patient's 
bowels should be kept open, and he should not eat anything 
that irritates the intestines. 2. The blood supply in the nerve 
centres should be regulated by strengthening the vaso-motor 
system. 3. All psychic excitation must be removed. Bromides 
may be used to quiet the nerves but depressed patients may be 
given stimulants. 4. There should be a general building up 
of the nervous system by means of hydro-therapeutics and 
electricity. The constant current is used for the vaso-motor 
system and static electricity to modify nutrition in general. If 
the speech centre is to be innervated the anode is placed on the 
head over the speech centre and the cathode in the neck. 
Gruenbaum galvanizes the lips, tongue, palate and larynx, 
especially with children. 

Gutzmann thinks medicines should ordinarily not be u.sed, 
though in extremely nervous cases, where hydro-therapeutics 
fail, he uses mono bromide of camphor in doses of o. 3 to o .5, 
three times a day. He uses the current only for the larynx 
when it shows spasmodic disturbances — anode on the larynx, 
cathode in the neck with a current less than one ten thou- 
sandth of an ampere. The removal of physical abnormalities 
should be placed in the hands of a physician. 

Makuen says all irregularities of a structural or pathologic 
character should be corrected. Free action of the tongue 
should be made possible by snipping the freuum if it be too 
short, and, if necessary, by a division of the anterior fibres of 
the genio-hyoglossus muscle. Aside from this, the treatment 
must be educational. Bernard always prescribes a compound 
of arsenic and strychnine — a method not approved by the best 
writers in this field. 

Severe costiveness seems to be common among stutterers. 
Ssikorski sa5'S it is one of the most common complications ot 
stuttering, even cases of many days' standing are found — a 
condition which always increases stuttering. Gutzmann, in 
his clinical experience with stutterers, has found cases of con- 
stipation lasting as long as two weeks without yielding to the 
most energetic means. It is quite evident that in such cases 
proper dieting should be carefully carried out in connection 
with abundant exercise in the open air. Since eneuresis noc- 
iurna is very common with stutterers, as some think it is, the 
amount of fluid taken in the afternoon should in such cases, in 
addition to the above precautions, be reduced to a minimum. 
These regulations bring about healthy sleep, an absolute essen- 
tial to the physical and psychical well-being of the child. 



SPEECH-DEVElvOPMENT IN THE CHILD. 47 

Aud when we consider that onanism is quite common among 
stutterers, as is observed by a number of writers, the need of 
proper exercise, proper dietetics, and proper bathing becomes 
all the more emphatic. 

Whether hypnotism should be used is an open question. 
Coen (49:170) would not use it. The temporary relief which 
it brings is too costly, he says, since oft repeated hypnotism 
gives permanent injury to the nervous system. Chervin 
(483:202) says hypnotism has a tendency to increase the 
patient's already too great excitabilit3% and to weaken the 
already too weak will and hence he has nothing to gain by it. 
Gutzmann (59) agrees with the above authors as to the injury 
it may cause and would use it onh^ as an ultimo ratio. Den- 
hardt does not believe in it and Berkhan leaves the question 
open though he has tried it with no satisfactory results. lyaubi 
agrees with Gutzmann that in most cases one can get along 
without it, but holds that a physician may use it with a good 
conscience if he finds it more interesting or if he thinks it ena- 
bles him to reach his goal quicker (68:129). Heymann 
(61:206) says hypnotism should in no case be left untried, and 
Gruenbaum (54:58) uses it to cure the slight paralysis of the 
speech centre which, he says, is the cause of stuttering, and 
thinks that hypnotism in the hands of the physician has be- 
come a blessing for man. 

The length of the course to obtain a perfect cure varies. 
Klencke makes the course from 5-6 months; Coen from 4-5 
months. Ssikorski says 6 months is probablj' the average. 
Gutzmsnn says a course of 2-3 months is sufiicient. Lieb- 
mann's course is 4 weeks with half- hour sessions, daily. Cher- 
vin's course is 3 weeks, but at the end of his cour.se he considers 
the patient only convalescent; a good, serious student should 
continue his exercises one month longer, working 2-3 hours 
a day. Denhardt's course is only 16 days, but he drills his 
patients 5 hours each day. It is quite evident, as all writers 
point out, that the length of the course depends upon many 
different things, such as the nervous condition of the patient, 
his general health, the severity of the trouble,' the interest the 
patient manifests in his cure, etc. It is difficult to give a defi- 
nite prognosis even after a preliminary examination. It is also 
quite possible that the length of the course may vary with the 
method. 

Stuttering is treated so successfully at the present that where 
free public courses are offered there is very little excuse for a 
youth to be afflicted with the trouble. ' Colombat, 1827- 1840, 
had 428 patients of whom 52% were cured, 21% improved, 
and 27% were dismissed as failures. Blume, in the early 40's, 
reported 70% cured of a total number of 40. Coen, in 1886, 



48 SPKECH-DEVELOPMENT IN THE CHILD. 

gives his results as follows: Cured 60%, improved 30%, fail- 
ures 10%. Berkhan directed public courses in Brunswick, 
1883-1885, which were attended by 96 patients — the worst stut- 
terers in the communitj' were selected. Of the.se 65 were 
cured, 30 improved, and i failed. There were 25 relapses in 
all. Gutzmaun gives the result of public courses in 46 Ger- 
man cities. These courses were attended by 1,390 stutterers of 
whom 72.7% were cured, 23.6% were improved, and 3.7% 
were failures. Of about 1,000 patients who attended A. Gutz- 
mann's polyclinic, 87% were cured, 10% improved, and 3% 
were failures; 5% of the cases relapsed. Of 600 patients who 
took private instruction from Dr. H. Gutzmann, 89% were 
cured, 9% improved, and 2% failed. Of the first 400 5% 
relapsed, but of the second 200 only ^%. Of 700 patients 
who attended his polyclinic, 1892-1898, the results were not so 
good on account of irregularity of attendance. Of 95 patients 
who took Oltuszewski's complete course, 87 were cured and 8 
very much improved, and he thinks they would have been 
cured had they repeated the course. Dr. R. Coen's report of 
1901, of the public cour.ses for stutterers in Vienna for the pre- 
ceding 10 years is as follows: Number that attended 158, 
cured 60%, improved 30%, failures 10%. He ascribes the 
failures entirely to laziness and irregularity of attendance. 
Chervin (48a:24i) says success is always certain if the subject 
is docile, attentive, diligent, and persevering, but those quali- 
ties are indispensable. 

These data show that stuttering is a disturbance that is quite 
curable. So much so that in some countries of Europe great 
efforts are made to relieve the suffering. Denmark has a pub- 
lic hospital for the cure of speech defects, and also offers public 
courses of treatment to children of school age. In Germany 
public courses are offered to school children in probably all 
communities where there are enough children with defective 
speech to make a course advisable. There are also several 
private clinics in charge of thorough specialists. Hungarj' 
also offers public courses to school children. It also has a cen- 
tral hospital where normal courses are oflfered to teachers at 
the expense of the State. A careful census is taken of the 
children with defective speech in the different communities, 
and those that have the greatest number of children with 
speech defects are given the first opportunity to send teachers 
to these teachers' courses. The number that may attend these 
courses at any one time is limited. In Russia and France 
there are clinics for speech defects, but whether there are pub- 
lic courses for children the writer was not able to ascertain. 
From private correspondence it seems that no statistics of 



SPEECH- DEVELOPMENT IN THE CHILD. 49 

speech defects exist and no public courses are offered in Eng- 
land.^ 

In this country very little is done outside of private institu- 
tions, the high scientific character of some of which seems to 
be doubtful. Some directors of private institutions have their 
methods copyrighted — a cheap method of advertising an 
assumed originality — and one even courts patronage by dispar- 
aging the work of other institutions. The only public effort 
in this country to correct speech defects, as far as the writer 
knows, is in the Philadelphia Polyclinic where there is a de- 
partment of speech defects in charge of Dr. Makuen. When 
we consider that there are probably over 200,000 stutterers 
and nearly 280,000 stammerers in the United States we can 
realize that it would be a proper function of the State to fur- 
nish measures of relief. 

Furthermore, the classroom teacher in the schools should 
have a general knowledge of functional speech disturbances. 
Worry, embarrassment, excitement, etc., are immediate causes 
of speech defects. If the school is a place of nervous tension; 
if the child is constantly worried with adult forms and abstrac- 
tions ill- fitted for its little mind; if it is a.sked to express its 
confused ideas under the eye of a critical teacher who perhaps 
considers her day's work to consist of 5 or 6 long, weary hours 
of wearisome labor — we have conditions for functional speech 
disturbances to set in, especially so since oral speech is not 
absolutely fixed till early adolescence. The school should 
rather use its opportunities to cultivate good oral language by 
means of stories, conversations and other oral exercises given 
sympathetically under the influence of a good model. The 
high percentages of stuttering during the first few years of 
school life is probably largely due to nerve tension^ and could 
be reduced considerably if the child in all cases had high 
minded teachers who understand child-nature, and who find 
their own life in the happy, exuberant life of the child; teach- 
ers who know how to subordinate deadening forms and can 
make the life of the school so free and so unrestrained, that 
fear, worry and its train of evils are unknown in their presence 
— teachers who can live with the child and organize its wealth 
of incoming information from the child's viewpoint, and en- 
courage it to react with oral expression as simple, as unaf- 
fected, as natural as the life of the child is itself. 

We may summarize thus the following points concerning 
speech defects: 



^ For information on this subject I am indebted to the kindness of 
Dr. R. Langdin Down, of Hampton Wick, Miss Kate Stevens and Mr. 
Wm. van Praagh, of London, England. 

^ Hartwell thinks it is due to bad methods of teaching reading — a 
thought which deserves serious consideration. 



LIBRftRY OF CONGRESS 




019 821 456 5 

50 SPEECH-DEVELOPMENT IN THE CHILD. 

1 . Inheritance seems to be a predisposing factor. 

2. Anything that disturbs the nervous system of the child 

may be an immediate cause, especially acute diseases. 

3. Suggestion is a factor in the spread of the disease. 

4. Stuttering is a children's disease. 

5. Second dentition and puberty are periods that favor stut- 

tering. 

6. Boys are more subject to the trouble than girls. 

7. It probably retards pupils in their school work. 

8. Stutterers are not mentally inferior. 

9. Speech defects are often the source of severe psychical 

depression. 

10. The seriousness and the spread of the trouble is such that 

it deserves more attention from the public and the 
specialist than is given it in this country at the present 
time. 

1 1 . Stuttering and stammering are, with probably very few 

exceptions, curable. 

I wish to acknowledge my great indebtedness to President 
G. Stanley Hall for suggesting the general topic of this study, 
and for valuable suggestions and criticisms; to the other mem- 
bers of the department faculty for suggestions; to Mr. Louis 
N. Wilson, Librarian of the University, for invaluable aid in 
securing the literature and in gathering the data; and to Mr. 
Samuel S. Green, Librarian of the Worcester Public Library, 
for various courtesies. 

The bibliography which follows contains onl)'' those works 
which are referred to in the text. No. 84 contains a good 
bibliography of the older works on stuttering, and Wilson's 
bibliography is the standard in child study. The Voice, a 
magazine published in Albany, N. Y., 1879-85, and later in 
New York City, has translations of some of the earlier methods 
practiced in Europe for the cure of stuttering. The student 
should always consult the standard bibliographies in Child 
Study, medicine, and psychology. Reference to the bibliogra- 
phy is by number; (25:37) means No. 25, Shultze, F., Die 
Sprache des Kindes, page 37. 

Bibliography — Normal Development. 

I AmenT, W. Begriff uad Begriffe der Kindersprache. Samml. 

V. Abh. a. d. Geb. d. Pad. Psy. u. Physiol., 1902, Vol. V, No. 4, 

pp. 85. 
2. Die Entwickelung von Sprechen und Denkeu beim 

Kinde. lycipzig, 1899, pp. 213. 

3. Baldwin, J. M. Mental Development in the child and the 

Race. London, 1895, pp. 496. 

4. CoMPARYE, G. L'Evolution Meutale et Morale De L'Enfant. 

Paris, 1893, pp. 371. 



LIBRARY OF CONGRESS 



019 821 456 5 



Hollinger 

pH 8.5 

Mill Run F3.1719 



